Search › Pennsylvania › 2255A2300X
Shyann Wallace, ATC, LAT
NPI 1710524913 · on the registry since 2019 · sole proprietor
Practice
- Address
- 1150 Harvest Dr
Lebanon, PA 17046 - Phone
- (717) 376-9110
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Also registered as
- 2255A2300X
- Licence states on file
- PA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-01-11
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 Pennsylvania