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1720798325
LOGAN WALLACE
ANKENY, IA
NPI
1720798325
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IA 110010)
Enumeration Date
2022-12-05
Last Update Date
2022-12-05
Business Address
LOGAN WALLACE
715 SW ANKENY RD
ANKENY, IA 50023-9798
Phone number: 870-307-8900
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Mailing Address
LOGAN WALLACE
208 TODD CIR
AMES, IA 50014-7731
Phone number: 870-307-8900
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