MRS. Beverly Wallace, OTR/L

NPI #1174595367 in Bradenton, Florida

Provider Information

NPI Number: 1174595367
Entity Type: Individual
Name: MRS. Beverly Wallace, OTR/L
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Occupational Therapist
Credential: OTR/L
Enumeration Date: Feb 2, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 3911 GOLF PARK LOOP
Address 2: SUITE #105
City: Bradenton
State: Florida
ZIP Code: 34203-3453
Phone: (941) 756-1003

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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