Individual
ANIETIE UKPE-WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1705 WEBSTER STREET, ALAMEDA, CA 94501-9450
(510) 545-3541
Mailing address
3001 JORDAN RD, OAKLAND, CA 94602-3530
(914) 400-7681
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT297733
CA
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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