| Jennifer L Wallace, PT | |
|
3891 50th Ave S, Saint Petersburg, FL 33711-4811 | |
| (630) 554-4701 | |
| Not Available |
| Full Name | Jennifer L Wallace |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 3891 50th Ave S, Saint Petersburg, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306035431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 22282 (Florida) | Primary |
| 225100000X | Physical Therapist | 070.009079 (Illinois) | Secondary |
| Provider Name | Bayit Home Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1689201329 PECOS PAC ID: 8325461551 Enrollment ID: O20200707002046 |
| Provider Name | Qrm Plus Florida Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1851061394 PECOS PAC ID: 8729479563 Enrollment ID: O20220105000497 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer L Wallace, PT 3891 50th Ave S, Saint Petersburg, FL 33711-4811 Ph: (630) 554-4701 | Jennifer L Wallace, PT 3891 50th Ave S, Saint Petersburg, FL 33711-4811 Ph: (630) 554-4701 |
Constance Jean Kershner, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5101 Brittany Dr S Ste 16, Saint Petersburg, FL 33715 Phone: 727-308-9848 Fax: 727-502-6027 | |
Cherie Lynne Waring, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 352 22nd Ave Se, Saint Petersburg, FL 33705 Phone: 727-894-2355 | |
Dr. Kelli Anne Faville, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6775 40th Ave N, Saint Petersburg, FL 33709 Phone: 727-803-1002 | |
Sly Edwards, Physical Therapist Medicare: Medicare Enrolled Practice Location: 8950 Dr Martin Luther King Jr St N, Saint Petersburg, FL 33702 Phone: 727-520-0800 | |
Dr. Kenneth John Clark Jr., DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 6619 1st Ave S, Saint Petersburg, FL 33707 Phone: 417-315-5577 | |
Dr. Mary Wesley Garner, D.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 801 6th St S, Saint Petersburg, FL 33701 Phone: 727-767-4257 | |
Beach Baby Pediatric Therapy, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5042 42nd St S, Saint Petersburg, FL 33711 Phone: 727-871-2784 |