Marie L. Wallace, CPCPERMITIP150410
Marie L. Wallace, CPCPERMITIP150410 is a Rehabilitation Practitioner in Las Vegas, Nevada. Practices as a sole proprietor. Registered with an NPI since 2012.
- In the registry since
- 2012
Practice location Address checks out
3606 N Roncho Dr Ste 102Las Vegas, NV 89130
Phone: (504) 400-5768
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Rehabilitation Practitioner (primary) | Taxonomy 225400000X |
|---|
Record details
| NPI number | 1548525934 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | CPCPERMITIP150410 |
| Sole proprietor | Yes |
| NPI enumerated | July 11, 2012 |
| Last updated in NPPES | May 15, 2015 |
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