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Individual

MRS. RACHEL L WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
801 MEDICAL DR, LIMA, OH 45804-4099
(419) 222-6622
(419) 222-4069
Mailing address
2950 N THAYER RD, LIMA, OH 45801-9770
(419) 224-7660

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000841
OH

Other

Enumeration date
05/04/2007
Last updated
07/08/2007
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