Individual
MR. EDWIN RUSH WALLACE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
100 PLAINSBORO RD, PLAINSBORO, NJ 08536-1914
(571) 370-3686
(571) 370-3687
Mailing address
100 PLAINSBORO RD, PLAINSBORO, NJ 08536-1914
(609) 945-5724
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305005465
VA
225100000X
Physical Therapist
Primary
CP031482T
NJ
Other
Enumeration date
12/07/2007
Last updated
10/31/2024
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