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1902271869
ALAN WILLIAM WALLACE
COLUMBUS, OH
NPI
1902271869
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OH AT-4473)
Enumeration Date
2015-12-03
Last Update Date
2015-12-03
Business Address
Mr. ALAN WILLIAM WALLACE ATC, CSCS, PES
2281 ANTIGUA DR APT. 1C
COLUMBUS, OH 43235-6122
Phone number: 412-638-7071
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Mailing Address
Mr. ALAN WILLIAM WALLACE ATC, CSCS, PES
2281 ANTIGUA DR APT. 1C
COLUMBUS, OH 43235-6122
Phone number: 412-638-7071
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