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1710240635
ANN ELIZABETH WALLACE
SALT LAKE CITY, UT
NPI
1710240635
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: UT 8336770-4201)
Enumeration Date
2012-06-18
Last Update Date
2022-02-11
Business Address
-- ANN ELIZABETH WALLACE OTR/L
1138 E WILMINGTON AVE
SALT LAKE CITY, UT 84106-2819
Phone number: 801-581-2221
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Mailing Address
-- ANN ELIZABETH WALLACE OTR/L
PO BOX 511258
LOS ANGELES, CA 90051-7813
Phone number: 801-587-6303
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