MR. John Robert Wallace, MSPT
NPI #1275663916 in Nags Head, North Carolina
Provider Information
- NPI Number
- 1275663916
- Entity Type
- Individual
- Name
- MR. John Robert Wallace, MSPT
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physical Therapist
- Credential
- MSPT
- Enumeration Date
- Mar 6, 2007
- Last Updated
- Mar 10, 2020
Practice Location
- Address
- 103 W WOODHILL DR
- Address 2
- SUITE A
- City
- Nags Head
- State
- North Carolina
- ZIP Code
- 27959
- Phone
- (252) 441-8580
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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