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

MS. EILEEN WALLACE, ATC, PTA

Active Sole Proprietor

MS. EILEEN WALLACE, ATC, PTA is a Athletic Trainer healthcare provider located in LONG BRANCH, New Jersey. NPI 1568585362 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · LONG BRANCH, NJ

Registration Details

NPI Number
1568585362
Provider Type
Individual
Gender
Female
NPI Issued
Apr 8, 2007 (19.345921933567 yrs)
Last Updated
Jul 21, 2022
License
25MT00040000 (NJ)
Sole Proprietor
Yes

Practice Information

Address
10 ARTHUR AVE
LONG BRANCH, NJ, 077406402
Browse NJ providers · Browse ZIP 07740
Phone
7322223839
Primary Specialty
Athletic Trainer
2255A2300X

Other Athletic Trainer Providers in LONG BRANCH, NJ

Name Credential NPI
MELINDA MAE BRENNER ATC, CSCS 1083884506
KIM SMALL ATC 1023421542
JOSEPH PAUL GIACOMO 1609394816
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.