Search › Oklahoma › 103TR0400X
Theresa Wallis
NPI 1639509862 · on the registry since 2013 · sole proprietor
Practice
- Address
- 201 N Broadway Ave
Shawnee, OK 74801 - Phone
- (580) 748-0342
- Fax
- (405) 386-3213
Registry record
- Primary taxonomy
- 103TR0400X
103TR0400X
- Sex
- Female
- Record last updated
- 2013-11-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma