Collin Wallace (NPI# 1568830719, PAC ID# 0042591109) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1568830719 |
| PAC ID by PECOS | 0042591109 |
| Professional Enrollment ID | I20170103001453 |
| Full Name | Collin Wallace |
| Organization Legal Name | OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES RIVERVIEW, LLC |
| Address |
11375 Big Bend Rd Riverview FL 33579-7183 |
| Phone Number | 8138058167 |
| Gender | M |
| Graduation Year | 2015 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 4688985567 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 11375 Big Bend Rd, Riverview, FL 33579-7183 | 8138058167 | OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES RIVERVIEW, LLC |
| Organization Legal Name | OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES RIVERVIEW, LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mandy Sue Huster | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Douglas D Buethe | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Thomas Michael Braaten | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Katelin A Smigielski | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Stephanie M Bridwell | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Alyssa N Mclean | Occupational Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Molly Marie Knight | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Emilee Sobucki | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Street Address |
11375 BIG BEND RD |
| City | RIVERVIEW |
| State | FL |
| Zip | 33579-7183 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mandy Sue Huster | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Douglas D Buethe | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Thomas Michael Braaten | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Katelin A Smigielski | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Stephanie M Bridwell | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Alyssa N Mclean | Occupational Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Molly Marie Knight | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Emilee Sobucki | Physical Therapy | Optimal Performance and Physical Therapies Riverview, LLC | 11375 Big Bend Rd, Riverview, FL 33579-7183 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Linh T Nguyen | Internal Medicine | Tampa General Medical Group Inc | 10647 Big Bend Rd, Suite 212, Riverview, FL 33579-7176 |
| Nancy L Calderon-polanco | Nurse Practitioner | Tampa General Medical Group Inc | 10647 Big Bend Rd, Suite 212, Riverview, FL 33579-7176 |
| David J Vargas | Family Practice | Tampa General Medical Group Inc | 10647 Big Bend Rd, Suite 212, Riverview, FL 33579-7176 |
| Prema L Ramsahai | Family Practice | Tampa General Medical Group Inc | 10647 Big Bend Rd, Suite 212, Riverview, FL 33579-7176 |
| Craig Andrew Kalik | Allergy/immunology | Partners In Allergy and Asthma Care Pa | 13105 Elk Mountain Dr, Riverview, FL 33579-7184 |
| Kathleen G Likar | Nurse Practitioner | Partners In Allergy and Asthma Care Pa | 13105 Elk Mountain Dr, Riverview, FL 33579-7184 |
| Alan Barton Halsey | Allergy/immunology | Partners In Allergy and Asthma Care Pa | 13105 Elk Mountain Dr, Riverview, FL 33579-7184 |
| Suzan S Pae | Allergy/immunology | Partners In Allergy and Asthma Care Pa | 13105 Elk Mountain Dr, Riverview, FL 33579-7184 |
| Zachary Isoma | Psychologist, Clinical | 10732 Ketchum Valley Dr, Riverview, FL 33579-7185 | |
| Rodney D Rodrigo | Interventional Pain Management | Interventional Pain Specialists of Southwest Florida LLC | 10730 Ketchum Valley Dr, Riverview, FL 33579-7185 |
| Find all physicians in zip 33579 | |||
| City | RIVERVIEW |
| Zip Code | 33579 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | RIVERVIEW + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Collin Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.