Individual
DEVON WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
101 W 14TH ST, FRONT ROYAL, VA 22630-3607
(540) 636-3500
(540) 636-3502
Mailing address
1808 PLAZA DR, WINCHESTER, VA 22601-6365
(540) 665-2750
(540) 665-2749
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211669
VA
Other
Enumeration date
12/20/2017
Last updated
03/17/2018
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