Individual
SANDRA EUGENIA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
3627 ACORNRUN LN, SPRING, TX 77389-4721
(281) 651-7716
Mailing address
3627 ACORNRUN LN, SPRING, TX 77389-4721
(281) 651-7716
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
016400
TX
Other
Enumeration date
09/17/2007
Last updated
09/17/2007
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