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1962776948
MANDY L WALLACE
FLORENCE, SC
NPI
1962776948
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: SC 4051)
Enumeration Date
2012-03-08
Last Update Date
2012-03-08
Business Address
MS. MANDY L WALLACE MSRPT
121 E CEDAR ST
FLORENCE, SC 29506-2576
Phone number: 843-661-3426
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Mailing Address
MS. MANDY L WALLACE MSRPT
1465 NORWOOD RD
OLANTA, SC 29114-9533
Phone number: 843-687-2068
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