Individual
SARA ELIZABETH WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1685 W 2200 S, SALT LAKE CITY, UT 84119-1456
(801) 887-5455
Mailing address
930 N 1300 W, SALT LAKE CITY, UT 84116-3880
(801) 721-9228
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7321736-2401
UT
Other
Enumeration date
05/22/2009
Last updated
05/22/2009
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