Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LAURALEE WALLACE
Active Sole ProprietorLAURALEE WALLACE is a Physical Therapy Assistant healthcare provider located in MONTAGUE, California. NPI 1326647447 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · MONTAGUE, CA
Registration Details
- NPI Number
- 1326647447
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 20, 2020 (5.8381926252943 yrs)
- Last Updated
- Oct 20, 2020
- License
-
PT20432 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
11239 BALL MTN LITTLE SHASTA RDMONTAGUE, CA, 960649682Browse CA providers · Browse ZIP 96064
- Phone
- 5303401490
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.