Individual
MS. SALLIE C WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
11000 HURTGEN FOREST RD, COLUMBIA, SC 29207-5020
(704) 995-1867
Mailing address
11000 HURTGEN FOREST RD, COLUMBIA, SC 29207-5020
(803) 751-6609
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1697
SC
Other
Enumeration date
05/01/2006
Last updated
10/01/2025
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