Individual
SIRENA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5100 ELDORADO PKWY, #102-20TRLL, MCKINNEY, TX 75070-6510
(469) 310-1700
(469) 310-1701
Mailing address
5855 MILTON ST, DALLAS, TX 75206-4202
(469) 310-1700
(469) 310-1701
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2087653
TX
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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