Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brian Venson Wallace, DPT

Individual provider Physical Therapist · NPI 1154677359

Brian Venson Wallace, DPT is a Physical Therapist in Ridgeland, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2012
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

711 Avignon Dr
Ridgeland, MS 39157-5120
Phone: (601) 605-6777
Fax: (601) 607-1553
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT 4550 (MS)

Record details

NPI number1154677359
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedJuly 25, 2012
Last updated in NPPESJuly 25, 2012
Mailing address711 Avignon Dr, Ridgeland, MS 39157-5120

Other providers in Ridgeland