| Ellie Claire Wallace, PT, DPT | |
|
10165 E Hampton Ave Ste 11, Mesa, AZ 85209-3327 | |
| (480) 354-5424 | |
| Not Available |
| Full Name | Ellie Claire Wallace |
|---|---|
| Gender | Female |
| Speciality | Physical Therapy |
| Experience | 4 Years |
| Location | 10165 E Hampton Ave Ste 11, Mesa, Arizona |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962096891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 11-06685 (Kansas) | Secondary |
| 225100000X | Physical Therapist | 106104 (Iowa) | Secondary |
| 225100000X | Physical Therapist | CP034759T (Arizona) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ati Holdings Llc | 9537112719 | 366 |
| Independent Physical Therapy Of Georgia Llc | 2961312244 | 447 |
| Provider Name | Ati Holdings Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1396781050 PECOS PAC ID: 9537112719 Enrollment ID: O20061020000349 |
| Provider Name | Ati Holdings Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1396781050 PECOS PAC ID: 9537112719 Enrollment ID: O20061023000321 |
| Mailing Address | Practice Location Address |
|---|---|
| Ellie Claire Wallace, PT, DPT 1200 Corporate Dr Ste 400, Hoover, AL 35242-5424 Ph: (866) 518-0283 | Ellie Claire Wallace, PT, DPT 10165 E Hampton Ave Ste 11, Mesa, AZ 85209-3327 Ph: (480) 354-5424 |
Justin Dunaway, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6632 E Baseline Rd, Suite 102, Mesa, AZ 85206 Phone: 480-222-0655 Fax: 480-222-1457 | |
Deborah A Mordhorst, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2919 S Ellsworth Rd, Suite 111, Mesa, AZ 85212 Phone: 480-358-6767 Fax: 480-358-6885 | |
Anda Michelle Vaughn, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5358 E Baseline Road, Mesa, AZ 85206 Phone: 480-699-9224 | |
Joshua N Lacanlale, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 3035 S Ellsworth Rd, Bldg 4, #128, Mesa, AZ 85212 Phone: 480-357-6500 Fax: 480-357-6515 | |
Christopher Samuel Anderson, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1500 S Dobson Rd Ste 314, Mesa, AZ 85202 Phone: 480-833-7879 | |
Savannah Torrez, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2524 E Golden St, Mesa, AZ 85213 Phone: 575-499-4249 | |
Bloom Physical Therapy, Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 3035 S Ellsworth Rd Ste 128, Mesa, AZ 85212 Phone: 480-357-6500 |