Wallace, Kenneth

Wallace, Kenneth is an individual health care provider with primary practice located at 170 Corey Rd Brighton House Rehabilitation And Nursing Center, Brighton MA 02135. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Wallace, Kenneth can be contacted via phone (617) 731-0515.

Contact Information

Primary practice address
170 Corey Rd Brighton House Rehabilitation And Nursing Center Brighton MA 02135
Phone: (617) 731-0515
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 8869 Massachusetts

Profile Details

NPI number 1952787533
LBN Legal business name Wallace, Kenneth
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2015
Last updated Aug 5th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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