Lataunya B Wallace, P.T.
NPI #1891010435 in Clinton, Mississippi
Provider Information
- NPI Number
- 1891010435
- Entity Type
- Individual
- Name
- Lataunya B Wallace, P.T.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physical Therapist
- Credential
- P.T.
- Enumeration Date
- Apr 6, 2010
- Last Updated
- Apr 6, 2010
Practice Location
- Address
- 102 WOODCHASE PARK DR
- City
- Clinton
- State
- Mississippi
- ZIP Code
- 39056-4113
- Phone
- (601) 924-7043
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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