KELLY LYNN WALLACE

LOS ANGELES, CA
NPI1750268520
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: CA  310150)
Additional Taxonomies225100000X Physical Therapist
(Licence: FL  PT43619)
225100000X Physical Therapist
(Licence: TX  1407872)
Enumeration Date2025-08-21
Last Update Date2026-05-26
Business Address
KELLY LYNN WALLACE DPT
6801 PARK TER STE 200
LOS ANGELES, CA 90045-1546
Phone number: 310-665-7100
Mailing Address
KELLY LYNN WALLACE DPT
780 E DORCHESTER DR
SAINT JOHNS, FL 32259-6287
Phone number: