Individual
MR. ANTHONY PAUL WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
5255 EL CAMINO REAL STE C, ATASCADERO, CA 93422-3351
(805) 237-0272
(805) 237-2416
Mailing address
5255 EL CAMINO REAL STE C, ATASCADERO, CA 93422-3351
(805) 237-0272
(805) 237-2416
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10294
CA
Other
Enumeration date
07/12/2005
Last updated
08/10/2022
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