Marisa Wallace, DPT

NPI #1861115362 in Hampstead, North Carolina

Provider Information

NPI Number: 1861115362
Entity Type: Individual
Name: Marisa Wallace, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: Sep 21, 2022
Last Updated: Nov 21, 2025

Practice Location

Address: 14057 US HIGHWAY 17 STE 230
City: Hampstead
State: North Carolina
ZIP Code: 28443-3999
Phone: (910) 821-3377

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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