Brandon W Wallace (NPI# 1700395274, PAC ID# 0244506111) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1700395274 |
| PAC ID by PECOS | 0244506111 |
| Professional Enrollment ID | I20171019002697 |
| Full Name | Brandon W Wallace |
| Organization Legal Name | MICHIGAN REHABILITATION SPECIALISTS OF FOWLERVILLE LLC |
| Address |
29900 Southfield Rd Southfield MI 48076-2090 |
| Phone Number | 2486630400 |
| Gender | M |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 6204730393 |
| Number of Group Practice Members | 183 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 46591 Romeo Plank Rd, Suite 115, Macomb, MI 48044-5705 | 5862503300 | VMS OF MACOMB TWP LLC |
| 1515 N Telegraph Rd, Ati Physical Therapy, Monroe, MI 48162-5139 | 7342424866 | MICHIGAN REHABILITATION SPECIALISTS OF FOWLERVILLE LLC |
| 29900 Southfield Rd, Southfield, MI 48076-2090 | 2486630400 | MICHIGAN REHABILITATION SPECIALISTS OF FOWLERVILLE LLC |
| Organization Legal Name | MICHIGAN REHABILITATION SPECIALISTS OF FOWLERVILLE LLC |
| Physicians | 228 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yiling Ran | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 35724 Van Dyke Ave, Sterling Heights, MI 48312-3564 |
| Roman Glazewski | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 7715 26 Mile Rd, Washington, MI 48094-2804 |
| Dalton Greyerbiehl | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 23143 Woodward Ave, Ati Physical Therapy, Ferndale, MI 48220-1360 |
| Craig James Obrock | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 4379 E Grand River Ave, 12 Ati Physical Therapy, Howell, MI 48843-6583 |
| Abbey Renee Cramer | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 73 W 4th St, Ati Physical Therapy, Suttons Bay, MI 49682-9487 |
| Caitlyn O'neil Smith | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 4765 Jackson Rd, Suite B, Ann Arbor, MI 48103-1847 |
| Michael Pieter Bates | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 5849 W Saginaw Hwy, Ati Physical Therapy, Lansing, MI 48917-2460 |
| Brooke Grime | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 5246 N Royal Dr B, Ati Physical Therapy, Traverse City, MI 49684-6984 |
| Amanda Cawley | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 2700 Orchard Lake Rd, Keego Harbor, MI 48320-1445 |
| Teresa Passamani | Physical Therapy | Michigan Rehabilitation Specialists of Fowlerville LLC | 1501 N Milford Rd, 201 Ati Physical Therapy, Milford, MI 48381-1049 |
| Street Address |
29900 SOUTHFIELD RD |
| City | SOUTHFIELD |
| State | MI |
| Zip | 48076-2090 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy M Bakalar | Nurse Practitioner | Carolyn E Guidot Md PC | 18161 W 13 Mile Rd, Suite E1, Southfield, MI 48076-1113 |
| Raka Mahajan | Allergy/immunology | Suresh Anne Md PC | 18161 W 13 Mile Rd C, Asthma Allergy and Immunology Center, Southfield, MI 48076-1113 |
| Lyle S Grant | Family Medicine | 18161 W 13 Mile Rd, Suite E3, Southfield, MI 48076-1113 | |
| Katherine R Shaw | Nurse Practitioner | Carolyn E Guidot Md PC | 18161 W 13 Mile Rd, Suite E1, Southfield, MI 48076-1113 |
| Rao S Botta | Allergy/immunology | Suresh Anne Md PC | 18161 W 13 Mile Rd C, Asthma Allergy and Immunology Center, Southfield, MI 48076-1113 |
| Suresh Anne | Allergy/immunology | Suresh Anne Md PC | 18161 W 13 Mile Rd C, Asthma Allergy and Immunology Center, Southfield, MI 48076-1113 |
| Iqbal A Nasir | General Practice | 18161 W 13 Mile Rd, D4, Southfield, MI 48076-1113 | |
| Carolyn Elaine Guidot | Internal Medicine | Carolyn E Guidot Md PC | 18161 W 13 Mile Rd, Suite E1, Southfield, MI 48076-1113 |
| Jennifer R Hankinson | Nurse Practitioner | Carolyn E Guidot Md PC | 18161 W 13 Mile Rd, E1, Southfield, MI 48076-1113 |
| Susan Hyde Bakker | Clinical Social Worker | Personal and Family Adjustment Center PC | 30555 Southfield Rd, Suite 510, Southfield, MI 48076-1221 |
| Find all physicians in zip 48076 | |||
| City | SOUTHFIELD |
| Zip Code | 48076 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | SOUTHFIELD + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Brandon W 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.