Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. RANDALL ALLEN WALLACE, P.T.
ActiveMR. RANDALL ALLEN WALLACE, P.T. is a 2251E1200X healthcare provider located in OAKLAHOMA CITY, Oklahoma. NPI 1497820252 is currently active in the NPPES registry. Verify at CMS.
2251E1200X · OAKLAHOMA CITY, OK
Registration Details
- NPI Number
- 1497820252
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 21, 2006 (19.718357005722 yrs)
- Last Updated
- Sep 11, 2025
- Licenses
-
PT2855 (OK)PT2855 (OK)
Practice Information
- Address
-
409 E. CALIFORNIA AVE.OAKLAHOMA CITY, OK, 73104Browse OK providers · Browse ZIP 73104
- Phone
- 4058796766
- Fax
- 4058793493
- Primary Specialty
-
2251E1200X
2251E1200X
- Additional Specialty
- 2251E1200X
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.