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Individual

TAYLOR TIDWELL WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L, RN

Contact information

Practice address
2904 S WILSON DAM RD, MUSCLE SHOALS, AL 35661-3752
(256) 856-5800
Mailing address
407 W BRIGHTON AVE, MUSCLE SHOALS, AL 35661-3201
(256) 762-5576

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6039
AL

Other

Enumeration date
05/05/2025
Last updated
05/05/2025
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