Lisa N. Wallace, LPTA

Physical Therapy Assistant · Lagrange, GA

Individual Active NPI

NPI number 1801099767

Practice location

1514 Vernon Rd
Lagrange, GA 30240-4131
Phone
(706) 845-3192
Fax
(706) 845-3700

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NPI record

NPI
1801099767
Entity type
Individual (Type 1)
Enumeration date
June 7, 2007
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X PTA000264 GA

Mailing address

536 Pine Ave
Roanoke, AL 36274-1446
Phone
(334) 863-6844
Fax
(706) 845-3700

About Lisa Wallace

Lisa N. Wallace, LPTA is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 1514 Vernon Rd, Lagrange, GA 30240-4131. The NPI number 1801099767 was assigned on June 7, 2007 and the record was last updated on July 8, 2007.

Lisa Wallace lists a license in the registry: #PTA000264 (GA) 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 Lisa N. Wallace, LPTA?

The NPI number is 1801099767.

What is the phone number of Lisa Wallace?

The phone number listed for the practice location is (706) 845-3192.

Where is Lisa Wallace located?

1514 Vernon Rd, Lagrange, GA 30240-4131.

What is the taxonomy code for Lisa 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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