Individual
MRS. BETH ANN WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
4127 PROGRESS BLVD, PERU, IL 61354-1112
(815) 223-3201
(815) 223-3202
Mailing address
4127 PROGRESS BLVD, PERU, IL 61354-1112
(815) 866-2084
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147000988
IL
Other
Enumeration date
10/23/2012
Last updated
02/01/2024
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