Individual
HEATHER MARIE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1361 E CYPRESS AVE STE E, REDDING, CA 96002-0283
(530) 691-9940
Mailing address
3420 LITTLE ST, REDDING, CA 96003-2231
(530) 691-9940
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
12/01/2023
Last updated
12/01/2023
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