KEITH WALLACE

GILBERT, AZ
NPI1831577337
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: AZ  5853)
Enumeration Date2015-05-15
Last Update Date2015-05-15
Business Address
-- KEITH WALLACE
4902 S VAL VISTA DR SUITE B102
GILBERT, AZ 85298-7325
Phone number: 480-855-8866
Mailing Address
-- KEITH WALLACE
9432 E CONQUISTADORES DR
SCOTTSDALE, AZ 85255-4343
Phone number: 602-703-0748
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