Search › Mississippi › 225100000X
Kelly Wallace, PT
NPI 1760727283 · on the registry since 2012 · sole proprietor
Practice
- Address
- 7160 Tchulahoma Rd Ste 4
Southaven, MS 38671 - Phone
- (662) 349-2733
- Clinicians at this address
- 28
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2012-12-10
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 Mississippi