Gary Robert Wallace in Jackson - Physical Therapy Assistant
Gary Robert Wallace - NPI 1003009184
Gary Robert Wallace is a Physical Therapy Assistant in Jackson, Mississippi. Gary Robert Wallace practices all healthcare services and medical treatments related to Physical Therapy Assistant. The NPI Number for Gary Robert Wallace is 1003009184. The last update date is 2007-08-22.
Gary Robert Wallace's current location address is 13 Northtown Dr, Jackson, Mississippi. You can contact this provider via phone number 6012069195 and fax number 6019578391. The mailing address for Gary Robert Wallace is 13 Northtown Dr, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary Robert Wallace |
|---|---|
| Address | 13 Northtown Dr, Jackson, Mississippi |
| Phone Number | 6012069195 |
| Fax Number | 6019578391 |
| Sole Proprietor | N |
| Credentials | PTA |
NPI Number Detail
| NPI Number | 1003009184 |
|---|---|
| Provider Enumeration Date | 2007-08-22 |
| Last Updated Date | 2007-08-22 |
Provider Mailing Address Detail
| Address | 13 Northtown Dr |
|---|---|
| City | Jackson |
| State | Mississippi (MS) |
| Post Code | 39211 |
| Phone Number | 6012069195 |
| Fax Number | 6019578391 |
Provider's Primary Taxonomy Detail
| Speciality | Physical Therapy Assistant |
|---|---|
| Taxonomy | 225200000X |
| Licence No | A2636 |
|
Definition: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Post |
|
Post Comment/ Review Below
What is the unique identifier code issued to Gary Robert Wallace by the Centers for Medicare & Medicaid Services?
The Gary Robert Wallace has been assigned the NPI (National Provider Identifier) 1003009184. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Gary Robert Wallace is located?
The Gary Robert Wallace is situated at the following address: 13 Northtown Dr, Jackson, MS, 39211.
What is Gary Robert Wallace's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Gary Robert Wallace is Physical Therapy Assistant, and the taxonomy classification code that categorizes this area of expertise is 225200000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1003009184 to Gary Robert Wallace?
The Centers for Medicare & Medicaid Services assigned the 1003009184 to Gary Robert Wallace on 2007-08-22.
When was the information pertaining to Gary Robert Wallace most recently updated or revised?
The details related to Gary Robert Wallace, including its address, specialty, and other relevant information, were last updated or revised on 2007-08-22.
Address: 9600 Two Notch Rd, Columbia, SC
Address: South East Iowa Physical Therapy, Ottumwa, IA
Address: 3335 Meijer Dr, Toledo, OH
Address: 305 N Mckinney St, Sweeny, TX
Address: 9720 Stirling Rd, Cooper City, FL
Address: 4500 San Pablo Rd S, Jacksonville, FL
Address: 110 Woolmans Ln, Mount Laurel, NJ
Address: 2033 Long Branch Ln, Clearwater, FL
Address: 1536 E Silver Springs Blvd, Ocala, FL
Address: 2546 E 2nd St, Casper, WY
Address: 4609 Tipton Ln, Alexandria, VA
Address: 1634 W Ohio St # 2, Chicago, IL
Address: 819 S Wabash Ave, Chicago, IL
Address: 2107 Se 3rd Ave, Ocala, FL
Address: 225 Corporate Dr, Houma, LA