Individual
MS. MARY FRANCES WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3301 RIVER AVE, HUNTINGTON, WV 25705-2807
(304) 412-3992
Mailing address
970 NORWAY AVE, HUNTINGTON, WV 25705-3948
(304) 412-3992
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2006-2004
WV
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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