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1952052060
ALICIA A WALLACE
ALBERT LEA, MN
NPI
1952052060
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MN A1345)
Enumeration Date
2022-01-11
Last Update Date
2022-01-11
Business Address
ALICIA A WALLACE PTA
1861 EAGLE VIEW CIR
ALBERT LEA, MN 56007-1818
Phone number: 507-373-2040
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Mailing Address
ALICIA A WALLACE PTA
PO BOX 277
GENEVA, MN 56035-0277
Phone number: 507-383-4787
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