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Individual

DR. TERRANCE TERRELL WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.T

Contact information

Practice address
700 19TH ST S # 5-YT, BIRMINGHAM, AL 35233-1927
(205) 933-8101
Mailing address
3101 LORNA RD, 1325, BIRMINGHAM, AL 35216-5455
(205) 447-5570

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10546
AL

Other

Enumeration date
01/31/2009
Last updated
01/31/2009
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