National Provider Identifier Database

NICOLE M WALLACE, PT – NPI #1609089028
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

NICOLE M WALLACE, PT
913 FIRST COLONIAL RD STE 204
VIRGINIA BEACH, VA23454-3198
Phone: 757-550-0725
Fax:
Website:
Specialty Taxonomy Code
* Specialist 174400000X
Children 282NC2000X

* Indicates primary specialty

NPI Profile & details for NICOLE M WALLACE

NPI Number 1609089028
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 05/08/2007
Last updated 03/18/2019 - About 7 years ago
Sole proprietor1 Yes
Identifiers
  • VA License #: 2305203070
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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