Eric T Wallace, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11251 Issued in WI

Practice address

W5361 County Road KK Ste E
Appleton, WI 54915-7271

Phone

(920) 540-2344

Fax

(920) 779-1460

NPI assigned

Jun 4, 2009

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Motus RX Physical Therapy, LLC

  dba Eric Wallace

  • Physical Therapist
  • Appleton, WI
  • NPI 1326576794
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417183476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5361 COUNTY ROAD KK STE E",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549157271",
            "telephone_number": "920-540-2344",
            "fax_number": "920-779-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W5361 COUNTY ROAD KK STE E",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549157271",
            "telephone_number": "920-540-2344",
            "fax_number": "920-779-1460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2763 S Oneida St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543045122",
            "country_code": "US",
            "telephone_number": "920-540-2344",
            "fax_number": "920-779-1460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ERIC",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11251",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WI",
            "license": "11251-24",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth D Walker, RPH
• Lisa Anne Walker, COTA
• Shari Walker
• Amanda Wallace, APRN
• Anne Wallace
• Kristin Nicole Wallace, M.S., OTR
• Stephanie Mary Wallace, MD
• Keelyn Marie Wallenfang, APNP
• Tyler Jerome Wallenfang, PHARMD
• Walsh Dental Appleton, LLC (Walsh Dental Group)

• Physical Therapist in Appleton, WI
• Providers in Appleton, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.