Individual
NOLAN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
114 E 1ST ST STE 105, PAPILLION, NE 68046-2407
(402) 933-2010
Mailing address
114 E 1ST ST STE 105, PAPILLION, NE 68046-2407
(402) 933-2010
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4484
NE
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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