Michael Wallace

Physical Therapy Assistant · San Angelo, TX

Individual Active NPI

NPI number 1609356864

Practice location

5455 Knickerbocker Rd
San Angelo, TX 76904-7711
Phone
(325) 944-1600

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NPI record

NPI
1609356864
Entity type
Individual (Type 1)
Enumeration date
August 17, 2018
Last updated
August 17, 2018
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X 2027639 TX

About Michael Wallace

Michael Wallace is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 5455 Knickerbocker Rd, San Angelo, TX 76904-7711. The NPI number 1609356864 was assigned on August 17, 2018 and the record was last updated on August 17, 2018.

Michael Wallace lists a license in the registry: #2027639 (TX) for Physical Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Michael Wallace?

The NPI number is 1609356864.

What is the phone number of Michael Wallace?

The phone number listed for the practice location is (325) 944-1600.

Where is Michael Wallace located?

5455 Knickerbocker Rd, San Angelo, TX 76904-7711.

What is the taxonomy code for Michael Wallace?

The primary taxonomy code is 225200000X – Physical Therapy Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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