Individual
CHRISTOPHER GEORGE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
6595 ROOSEVELT BLVD, PHILADELPHIA, PA 19149-2998
(215) 743-2332
Mailing address
305 HAINES DR, NORTH WALES, PA 19454-2702
(215) 360-9314
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC017968
PA
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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