Individual
JAMES WALLENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
860 HAMPSHIRE RD, WESTLAKE VILLAGE, CA 91361-2803
(805) 852-5055
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
298494
CA
Other
Enumeration date
07/17/2020
Last updated
06/07/2024
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