Individual
SAVANNAH LYN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1818 W WORLEY ST, COLUMBIA, MO 65203-1038
(573) 214-3400
Mailing address
1294 COMMONS LOOP, FULTON, MO 65251-1456
(618) 340-5787
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2024001847
MO
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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