Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHELLE WALLACE, PT
Active Sole ProprietorMICHELLE WALLACE, PT is a Pediatric Rehabilitation Medicine healthcare provider located in TENAFLY, New Jersey. NPI 1477808947 is currently active in the NPPES registry. Verify at CMS.
Pediatric Rehabilitation Medicine · TENAFLY, NJ
Registration Details
- NPI Number
- 1477808947
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 19, 2012 (14.108875561158 yrs)
- Last Updated
- Jul 19, 2012
- License
-
40QA00591600 (NJ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
75 NORMAN PLTENAFLY, NJ, 076702537Browse NJ providers · Browse ZIP 07670
- Phone
- 7327610088
- Primary Specialty
-
Pediatric Rehabilitation Medicine
2081P0010X
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.