Wallace, Kelly
Wallace, Kelly is an sole proprietor health care provider with primary practice located at 7160 Tchulahoma Rd Ste 4 , Southaven MS 38671-9266. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Wallace, Kelly can be contacted via phone (662) 349-2733.Contact Information
Primary practice address
7160 Tchulahoma Rd Ste 4
Southaven MS 38671-9266
Phone: (662) 349-2733
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 1734 | Mississippi |
Profile Details
| NPI number | 1760727283 |
|---|---|
| LBN Legal business name | Wallace, Kelly |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 10th, 2012 |
| Last updated | Dec 10th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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