| Garrett Wallace, | |
|
4109 Highway 98 W, Summit, MS 39666-9132 | |
| (601) 276-3909 | |
| Not Available |
| Full Name | Garrett Wallace |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 7 Years |
| Location | 4109 Highway 98 W, Summit, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306339262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Professional Rehab Associates | 2567648777 | 6 |
| Provider Name | Professional Rehab Associates |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1801192307 PECOS PAC ID: 2567648777 Enrollment ID: O20110523000605 |
| Mailing Address | Practice Location Address |
|---|---|
| Garrett Wallace, 4109 Highway 98 W, Summit, MS 39666-9132 Ph: (601) 276-3909 | Garrett Wallace, 4109 Highway 98 W, Summit, MS 39666-9132 Ph: (601) 276-3909 |
Tyrea Dulaney, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4109 Highway 98 W, Summit, MS 39666 Phone: 601-276-3900 | |
Johnathan G Freeman, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4109 Highway 98 W, Summit, MS 39666 Phone: 601-276-3900 | |
Jonalyn Clark, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4109 Highway 98 W, Summit, MS 39666 Phone: 601-276-3900 | |
Kellye Reeves, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4109 Highway 98 W, Summit, MS 39666 Phone: 601-276-3900 | |
Rebecca Newman, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4109 Highway 98 W, Summit, MS 39666 Phone: 601-276-3900 | |
Dr. Brad Fortinberry, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 709 Robb Street, Summit, MS 39666 Phone: 601-248-8019 |