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Individual

DR. SHAWN G WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1805 COMMONS CIR STE 100B, YUKON, OK 73099-9519
(405) 467-4086
(405) 467-4387
Mailing address
1805 COMMONS CIR STE 100B, YUKON, OK 73099-9519
(405) 467-4086
(405) 467-4387

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1769
OK

Other

Enumeration date
02/05/2006
Last updated
01/21/2026
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