Mason Wallace
NPI #1033500525 in Alexandria, Virginia
Provider Information
- NPI Number
- 1033500525
- Entity Type
- Individual
- Name
- Mason Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Feb 5, 2015
- Last Updated
- Feb 5, 2015
Practice Location
- Address
- 209 MADISON ST
- Address 2
- SUITE LL2
- City
- Alexandria
- State
- Virginia
- ZIP Code
- 22314-1764
- Phone
- (703) 299-6688
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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