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1760626576
DAVID R WALLACE
OXFORD, MS
NPI
1760626576
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: MS PT2738)
Enumeration Date
2009-04-23
Last Update Date
2009-04-23
Business Address
-- DAVID R WALLACE PT
2170 S LAMAR BLVD
OXFORD, MS 38655-5224
Phone number: 662-234-8559
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Mailing Address
-- DAVID R WALLACE PT
2170 S. LAMAR BLVD
OXFORD, MS 38655
Phone number: 662-234-8559
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