Jennifer N Wallace, PTA is a
Physical Medicine & Rehabilitation physician based in Vandalia, Ohio. Jennifer N Wallace is licensed to practice in Ohio (license number PTA008822) and her current practice location is 40 Larry Ave, Vandalia, Ohio. She can be reached at her office (for appointments etc.) via phone at
(937) 304-9702.
NPI number for Jennifer N Wallace is 1851068910 and her current mailing address is 40 Larry Ave, Vandalia, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1851068910.
Physician's Profile
| Full Name | Jennifer N Wallace |
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| Gender | Female |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 40 Larry Ave, Vandalia, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1851068910
- Provider Enumeration Date: 08/26/2021
- Last Update Date: 08/26/2021
Medical Identifiers
Medical identifiers for Jennifer N Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1851068910 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | PTA008822 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jennifer N Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jennifer N Wallace, PTA
40 Larry Ave,
Vandalia, OH 45377-3010
Ph: () - | Jennifer N Wallace, PTA
40 Larry Ave,
Vandalia, OH 45377-3010
Ph: (937) 304-9702 |
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