ALAN WILLIAM WALLACE

COLUMBUS, OH
NPI1902271869
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OH  AT-4473)
Enumeration Date2015-12-03
Last Update Date2015-12-03
Business Address
Mr. ALAN WILLIAM WALLACE ATC, CSCS, PES
2281 ANTIGUA DR APT. 1C
COLUMBUS, OH 43235-6122
Phone number: 412-638-7071
Mailing Address
Mr. ALAN WILLIAM WALLACE ATC, CSCS, PES
2281 ANTIGUA DR APT. 1C
COLUMBUS, OH 43235-6122
Phone number: 412-638-7071