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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. ERIC T WALLACE, DPT

Active Sole Proprietor

DR. ERIC T WALLACE, DPT is a Physical Therapy Assistant healthcare provider located in APPLETON, Wisconsin. NPI 1417183476 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · APPLETON, WI

Registration Details

NPI Number
1417183476
Provider Type
Individual
Gender
Male
NPI Issued
Jun 4, 2009 (17.220418080344 yrs)
Last Updated
Jul 21, 2022
Licenses
11251-24 (WI)
11251 (WI)
Sole Proprietor
Yes

Practice Information

Address
W5361 COUNTY ROAD KK STE E
APPLETON, WI, 549157271
Browse WI providers · Browse ZIP 54915
Phone
9205402344
Fax
9207791460
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in APPLETON, WI

Name Credential NPI
MR. GERALD T TATE PT 1396747010
MR. PHILIP D SORENSON PT 1326040056
MR. JEFFREY S JETER PT 1134121858
MR. ROBERT P WORTH PT 1811999584
MR. TERRY J MOORE PT 1720080492
RONALD S MILLER PT 1336131465
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.