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Individual

VICTORIA PAIGE WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MYOFUNTIONAL THERAPY

Contact information

Practice address
5126 B AVE, LOXLEY, AL 36551-4536
(251) 895-9005
Mailing address
5126 B AVE, LOXLEY, AL 36551-4536
(251) 895-9005

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
02/02/2026
Last updated
02/02/2026
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