Judy Lynn Wallis PTA

NPI 1356558324 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1356558324
Gender Female
Enumeration Date 05/17/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
ST ANN'S HOME
2161 LEONARD NW
GRAND RAPIDS MI, 49504, US
Phone (616) 453-7715
Fax
Business Location
11044 TEFFT AVE NE
ROCKFORD MI, 49341-9717, US
Phone (616) 866-3008
Fax
Toxanomy
Taxonomy Code 225200000X
License State
License Number
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According to our database, Mrs. Judy Lynn Wallis PTA NPI is 1356558324, taxonomy code is 225200000X Judy Lynn Wallis PTA physically located at St Ann's Home, Grand Rapids MI, 49504. NPI Number Judy Lynn Wallis PTA has the Individual type.

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1356558324 NPI number is provided on an as is basis without warranty of any kind. 1356558324 is maintained by the National Plan & Provider Enumeration System. The contents of Judy Lynn Wallis PTA are for informational purposes only.