Ryan James Wallace, PT, DPT, OCS, MTC
NPI #1568420354 in Bonita Springs, Florida
Provider Information
- NPI Number
- 1568420354
- Entity Type
- Individual
- Name
- Ryan James Wallace, PT, DPT, OCS, MTC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapist
- Credential
- PT, DPT, OCS, MTC
- Enumeration Date
- May 2, 2006
- Last Updated
- May 12, 2015
Practice Location
- Address
- 25241 ELEMENTARY WAY
- Address 2
- STE 200
- City
- Bonita Springs
- State
- Florida
- ZIP Code
- 34135-7883
- Phone
- (239) 947-4184
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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