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Individual

MRS. VALERIE KAY WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAT ATC

Contact information

Practice address
263 SEABOARD LN, FRANKLIN, TN 37067-4877
(615) 591-6590
Mailing address
7481 CHRISTOPHER ST, FAIRVIEW, TN 37062-9307
(615) 686-3683

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0000001683
TN

Other

Enumeration date
01/03/2017
Last updated
01/03/2017
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