MICHAEL WALLACE

LOGANVILLE, GA
NPI1881368561
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: GA  PT015458)
Enumeration Date2021-08-05
Last Update Date2024-03-11
Business Address
Mr. MICHAEL WALLACE DPT
3440 HIGHWAY 81
LOGANVILLE, GA 30052-9112
Phone number: 770-554-5009
Mailing Address
Mr. MICHAEL WALLACE DPT
1017 CRYSTAL BROOK WAY
MONROE, GA 30655-7313
Phone number:
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