JORDEEN WALLACE

Physical Therapy Assistant

Active Individual
NPI: 1093856007

Practice Address

1100 N KENTUCKY AVE
West Plains, MO 65775

Phone: (417) 257-5959

Specialties

Specialty Code Primary License
Physical Therapy Assistant 225200000X Yes 11903 (MO)

Frequently Asked Questions

NPI 1093856007 is the National Provider Identifier for JORDEEN WALLACE, a Physical Therapy Assistant provider located in West Plains, MO. This NPI was enumerated on February 11, 2007.
JORDEEN WALLACE practices at 1100 N KENTUCKY AVE, West Plains, MO 65775.

Quick Facts

NPI
1093856007
Type
Individual
Enumerated
Feb 11, 2007
Last Updated
Jul 8, 2007

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