KELLY WALLACE

SOUTHAVEN, MS
NPI1760727283
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: MS  1734)
Enumeration Date2012-12-10
Last Update Date2012-12-10
Business Address
KELLY WALLACE PT
7160 TCHULAHOMA RD STE 4
SOUTHAVEN, MS 38671-9266
Phone number: 662-349-2733
Mailing Address
KELLY WALLACE PT
7160 TCHULAHOMA RD STE 4
SOUTHAVEN, MS 38671-9266
Phone number: