NPI 1164153409

Gayle Ann Wallace, PTA

Practitioner Physical Therapy Assistant Sterling Heights, MI

Practice location

Address: 40778 Rainier Dr, Sterling Heights, MI 48313-5367
Phone: (586) 819-6887

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 5502001041 (MI)

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Registry record

NPI: 1164153409
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Jun 2022
Record last updated: 17 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.