Individual
MELISSA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3685 MCCONNELLS HWY W, SHARON, SC 29742-5710
(803) 493-4407
Mailing address
3685 MCCONNELLS HWY W, SHARON, SC 29742-5710
(803) 493-4407
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1463
SC
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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