Donald D Wallace, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT017196 Issued in PA

Practice address

605 W State St
First Floor
Media, PA 19063-2620

Phone

(610) 566-7424

Fax

(610) 892-0489

NPI assigned

Mar 12, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1497078893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 W STATE ST",
            "address_2": "FIRST FLOOR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632620",
            "telephone_number": "610-566-7424",
            "fax_number": "610-892-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 W STATE ST",
            "address_2": "FIRST FLOOR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632620",
            "telephone_number": "610-566-7424",
            "fax_number": "610-892-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DONALD",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Ann Waldron, MSOT-R/L
• Lisa Ann Walker Bigelow, RN, MSN
• Stephen R Walker, M.D.
• Wall to Wall Speech Therapy LLC
• Cierra Wallace, COTA
• Catherine Waller, MD
• Daniel Edward Walls, PT
• Erin Michelle Walsh, NP
• Katharine Elizabeth Miller Walsh, CET I
• Tsailing Wang, MD

• Physical Therapist in Media, PA
• Providers in Media, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.