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

Jennifer L Wallace, PT

Individual provider Physical Therapist · NPI 1306035431

Jennifer L Wallace, PT is a Physical Therapist in Saint Petersburg, Florida. Licensed in Florida and Illinois. Registered with an NPI since 2007.

Licensed in
FL, IL
In the registry since
2007
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

3891 50th Ave S
Saint Petersburg, FL 33711-4811
Phone: (630) 554-4701
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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 22282 (FL)
Physical Therapist Taxonomy 225100000X · Licence 070.009079 (IL)

Record details

NPI number1306035431
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedOctober 15, 2007
Last updated in NPPESMay 3, 2010

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