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NPI Profile for NICOLE M WALLACE in VIRGINIA BEACH, VA.
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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Specialist |
174400000X | |||
Children |
282NC2000X | A0[7] | Hospital-Children’s (PPS excluded) |
| NPI # | 1609089028 |
|
| Status | Active | |
| Credentials | PT (Physical Therapist) | |
| Entity | Individual | |
| Enumeration date | 05/08/2007 | |
| Last updated | 03/18/2019 - About 7 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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NICOLE M WALLACE
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NICOLE M WALLACE, PT