Individual
MISS JENNIFER LYNN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1445 N LIMESTONE ST, GAFFNEY, SC 29340-4735
(864) 487-7874
(864) 487-7659
Mailing address
1445 N LIMESTONE ST, GAFFNEY, SC 29340-4735
(864) 487-7874
(864) 487-7659
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5605
SC
Other
Enumeration date
10/09/2007
Last updated
01/25/2022
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