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1760206460
JESSICA WALLACE
LA PLATA, MD
NPI
1760206460
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
Enumeration Date
2024-11-11
Last Update Date
2024-11-11
Business Address
JESSICA WALLACE
101 CENTENNIAL ST STE C
LA PLATA, MD 20646-5976
Phone number: 301-392-3700
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Mailing Address
JESSICA WALLACE
1911 S 21ST ST
ROGERS, AR 72758-6101
Phone number: 479-270-0588
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