Most Relevant Information
Provider Data
| NPI Number: | 1003075524 |
| Provider Name: | WENDY WALLACE PT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT005811L |
Most Important Dates
| Enumeration Date: | 06/09/2008 |
| Last Updated: | 06/10/2008 |
Provider Practice Location
550 N 12TH ST
LEMOYNE
PA
170431242
Practice Location Phone/Fax
| Phone: | 7177379818 |
| Fax: |
Provider Mailing Location
550 N 12TH ST
LEMOYNE
PA
170431242
Provider Mailing Phone/Fax
| Phone: | 7177379818 |
| Fax: |