Search › Missouri › 174400000X
Tara Wallace, LMT, MMP
NPI 1790124378 · on the registry since 2013 · sole proprietor
Practice
- Address
- 2633 Babble Creek Ln
O Fallon, MO 63368 - Phone
- (636) 577-1216
- Fax
- (636) 294-0837
Registry record
- Primary taxonomy
- 174400000X
174400000X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2013-06-18
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 Missouri