ELI WILLIAM WALLACE

LAFAYETTE, LA
NPI1891538070
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: LA  OTT.200733)
Enumeration Date2024-06-17
Last Update Date2024-06-17
Business Address
ELI WILLIAM WALLACE OT
400 POLLY LN
LAFAYETTE, LA 70508-4966
Phone number: 337-443-0652
Mailing Address
ELI WILLIAM WALLACE OT
105 CONCERTO CRST
DUSON, LA 70529-3352
Phone number: 337-258-5264
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