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1861115362
MARISA WALLACE
FAYETTEVILLE, NC
NPI
1861115362
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NC P21665)
Enumeration Date
2022-09-21
Last Update Date
2023-06-26
Business Address
MARISA WALLACE DPT
501 EXECUTIVE PL
FAYETTEVILLE, NC 28305-5390
Phone number: 910-423-5550
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Mailing Address
MARISA WALLACE DPT
5710 OLEANDER DRIVE STE 211
WILMINGTON, NC 28403-5390
Phone number: 910-398-6301
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