Individual
CHRISTINE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8230 OLD COURTHOUSE RD STE 350, VIENNA, VA 22182-3840
(703) 749-0223
Mailing address
6411 WHIPPANY WAY, BURKE, VA 22015-3428
(908) 244-4511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305205726
VA
Other
Enumeration date
02/21/2012
Last updated
01/08/2020
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