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1942551148
WHITNEY R WALLACE
LOUISVILLE, KY
NPI
1942551148
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32002004A)
Enumeration Date
2012-09-27
Last Update Date
2012-09-27
Business Address
-- WHITNEY R WALLACE COTA
303 N HURSTBOURNE PKWY 200
LOUISVILLE, KY 40222-5185
Phone number: 502-412-5847
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Mailing Address
-- WHITNEY R WALLACE COTA
306 CRESTVIEW DR
OWENSVILLE, IN 47665-9258
Phone number: 812-677-0312
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