| Linda W Wallace, PT | |
|
11740 Columbia St, Blakely, GA 39823-2574 | |
| (229) 724-4269 | |
| (229) 723-2354 |
| Full Name | Linda W Wallace |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 11740 Columbia St, Blakely, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184802787 | NPI | - | NPPES |
| 688951544A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT0009259 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Linda W Wallace, PT 11740 Columbia St, Blakely, GA 39823-2574 Ph: (229) 724-4269 | Linda W Wallace, PT 11740 Columbia St, Blakely, GA 39823-2574 Ph: (229) 724-4269 |
Jeffrey E. Tardif, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 11740 Columbia St, Blakely, GA 39823 Phone: 229-723-4241 | |
Nicholas James Long, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 11740 Columbia St, Blakely, GA 39823 Phone: 229-723-2930 |