Individual
MRS. ALYSON KING WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
642 N MAIN ST, MARION, VA 24354-3341
(276) 783-7529
Mailing address
924 N MAIN ST, MARION, VA 24354-4140
(276) 783-7529
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12359
TN
225100000X
Physical Therapist
Primary
2305203139
VA
Other
Enumeration date
04/19/2019
Last updated
05/13/2019
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