MRS. Laura Jean Wallace, LPTA

NPI #1558417436 in Medina, Ohio

Provider Information

NPI Number: 1558417436
Entity Type: Individual
Name: MRS. Laura Jean Wallace, LPTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: LPTA
Enumeration Date: Jan 25, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 4691 WINDFALL RD
City: Medina
State: Ohio
ZIP Code: 44256-8705
Phone: (330) 727-7751

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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