JASON SCOTT WALLACE

CAMARILLO, CA
NPI1891786646
Entity TypeIndividual
GenderMale
Sole Proprietor ?
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CA  AT5146)
Enumeration Date2005-11-01
Last Update Date2007-07-08
Business Address
MR. JASON SCOTT WALLACE PTA
2486 N PONDEROSA DR STE D-106
CAMARILLO, CA 93010-2376
Phone number: 805-484-5447
Mailing Address
MR. JASON SCOTT WALLACE PTA
4979 BURSON WAY
OXNARD, CA 93036-1017
Phone number: 805-671-5625
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