BASIA C. Z. WALLACE

CRYSTAL LAKE, IL
NPI1770351991
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: IL  056.015836)
Enumeration Date2023-12-18
Last Update Date2023-12-18
Business Address
DR. BASIA C. Z. WALLACE OTD, OTR/L
394 FEDERAL DR
CRYSTAL LAKE, IL 60014
Phone number: 815-459-3810
Mailing Address
DR. BASIA C. Z. WALLACE OTD, OTR/L
394 FEDERAL DR
CRYSTAL LAKE, IL 60014-6281
Phone number: 815-459-3810
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