Individual provider · Type 1 NPI

Nicole Marie Wallace, PT

Specialist · Virginia Beach, VA

NPI number 1609089028 Active

Practice location

913 First Colonial Rd Ste 204
Virginia Beach, VA 23454-3198

Call (757) 550-0725 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed
Children's Hospital 282NC2000X2305203070 (VA)

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.

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About NPI 1609089028

Nicole Marie Wallace, PT's National Provider Identifier is 1609089028, issued on May 8, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Virginia Beach, VA. The record was last updated on Mar 18, 2019.