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Individual

JOCELYN DIANE WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
1830 RADIUS DR APT 910, HOLLYWOOD, FL 33020-7716
(813) 407-9004
Mailing address
1830 RADIUS DR APT 910, HOLLYWOOD, FL 33020-7716
(813) 407-9004

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
FL

Other

Enumeration date
07/26/2017
Last updated
01/27/2020
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