Wallace Physical Therapy PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

WALLACE PHYSICAL THERAPY PC

Doing business as

Fyzical East Tucson

Practice address

250 S Vozack LN Ste C
Tucson, AZ 85748-4539

Phone

(202) 785-2025

Fax

(800) 392-0662

NPI assigned

Jul 5, 2006

Organization subpart

No

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

Authorized official

Name

Elena Merchand

Title

Owner

Phone

(520) 278-5202

Specialties & licenses 2

Addresses

Other names 1

• Fyzical East Tucson Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathleen Bornais Nichols, P.T.

  • Physical Therapist
  • Tucson, AZ
  • NPI 1588833099
  NPD (past)
• Kenneth Lee Diehl, P.T.

  • Physical Therapist
  • Kailua Kona, HI
  • NPI 1396841300
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716768000000",
    "number": "1861423394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S VOZACK LN",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857484539",
            "telephone_number": "520-278-5202",
            "fax_number": "800-392-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S VOZACK LN STE C",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857484539",
            "telephone_number": "202-785-2025",
            "fax_number": "800-392-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLACE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A",
        "authorized_official_last_name": "MERCHAND",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-278-5202"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical East Tucson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Walking in the Spirit Tucson LLC
• Angela D Wall, D.O.
• Conrad L Wall, MD
• Danielle Wall, MT-BC
• Kim Marie Wall, FNP-C
• Brooke Wallace, PHARMD
• Daniel Wallace, LMSW, LCSW
• Jan Ellen Wallace, LCSW
• Michelle Wallace, PHARMD
• Neil Wallace, MD

• Physical Therapy Clinic/Center in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Physical Therapy Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; 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.