Individual
MS. JAMIE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
469 W PUTNAM AVE, GREENWICH, CT 06830-6895
(203) 869-5546
Mailing address
469 W PUTNAM AVE, GREENWICH, CT 06830-6895
(203) 869-5546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
009438
CT
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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