Lauralee Wallace

NPI #1326647447 in Montague, California

Provider Information

NPI Number: 1326647447
Entity Type: Individual
Name: Lauralee Wallace
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: Oct 20, 2020
Last Updated: Oct 20, 2020

Practice Location

Address: 11239 BALL MTN LITTLE SHASTA RD
City: Montague
State: California
ZIP Code: 96064-9682
Phone: (530) 340-1490

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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