person
Andre Lamar Wallace
Massage Therapist in Philadelphia, Pennsylvania
NPI 1578178844

Andre Lamar Wallace is a Massage Therapist based in Philadelphia, PA. Andre Lamar Wallace practices in Philadelphia, PA. The NPI Number for Andre Lamar Wallace is 1578178844 and holds a License No. MSG007581 (Pennsylvania).

The current practice location address for Andre Lamar Wallace is 435 W Roosevelt Blvd Apt 2, Philadelphia, PA and can be reached out via phone at 215-435-5560.

Location: 435 W Roosevelt Blvd Apt 2, Philadelphia, PA, 19120-4148
person
Provider Profile Details
NPI Number
1578178844
Provider Name
Andre Lamar Wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
435 W Roosevelt Blvd Apt 2, Philadelphia, PA, 19120-4148
Phone Number
215-435-5560
Fax Number
Provider Enumeration Date
09/13/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
435 W Roosevelt Blvd Apt 2
City
State
Zip
19120-4148
Phone Number
215-435-5560
Fax Number
person
Provider Business Mailing Address Details
Address
435 W Roosevelt Blvd Apt 2
City
State
Zip
19120-4148
Phone Number
215-435-5560
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
License No.
MSG007581 (Pennsylvania)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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