Keith Wallace
Keith Wallace is an Occupational Therapy Assistant in Gilbert, Arizona. Practices as a sole proprietor. Licensed in Arizona.
- Licensed in
- AZ
- In the registry since
- 2015
Practice location Address checks out
4902 S Val Vista Dr Ste B102Gilbert, AZ 85298-7325
Phone: (480) 855-8866
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Occupational Therapy Assistant (primary) | Taxonomy 224Z00000X · Licence 5853 (AZ) |
|---|
Record details
| NPI number | 1831577337 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | May 15, 2015 |
| Last updated in NPPES | May 15, 2015 |
| Mailing address | 9432 E Conquistadores Dr, Scottsdale, AZ 85255-4343 |
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