MS. Eileen Wallace, ATC, PTA
NPI #1568585362 in Long Branch, New Jersey
Provider Information
- NPI Number
- 1568585362
- Entity Type
- Individual
- Name
- MS. Eileen Wallace, ATC, PTA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC, PTA
- Enumeration Date
- Apr 8, 2007
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 10 ARTHUR AVE
- City
- Long Branch
- State
- New Jersey
- ZIP Code
- 07740-6402
- Phone
- (732) 222-3839
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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