Individual
ERIK J WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
50 SHERRY AVE, PARK FALLS, WI 54552-1467
(715) 762-3212
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1296
WI
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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