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General NPI Number Information
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NPI Number | 1932925310
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Entity Type | Individual
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Provider Name | ALANA WALLACE PTA
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 650 9TH AVE SW STE 104
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City | BESSEMER
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State | AL
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Zip | 35022-4502
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Country | US
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Telephone | 205-425-5428
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Fax |
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Provider Business Mailing Address
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Address Line | 106 CHASE CREEK CIR
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City | PELHAM
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State | AL
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Zip | 35124-1766
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Country | US
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Telephone | 605-415-7684
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State | AL
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