Individual
DR. ERIC T WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
W5361 COUNTY ROAD KK STE E, APPLETON, WI 54915-7271
(920) 540-2344
(920) 779-1460
Mailing address
W5361 COUNTY ROAD KK STE E, APPLETON, WI 54915-7271
(920) 540-2344
(920) 779-1460
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11251
WI
2251X0800X
Orthopedic Physical Therapist
11251-24
WI
Other
Enumeration date
06/04/2009
Last updated
07/21/2022
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