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

Jill Wallace, PT

Individual provider Physical Therapist · NPI 1104883099

Jill Wallace, PT is a Physical Therapist in Waukesha, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.

Licensed in
WI
In the registry since
2006
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

W239N1812 Rockwood Dr Ste 100 Phcma Inc
Waukesha, WI 53188-1113
Phone: (262) 523-0310
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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 10232 (WI)

Record details

NPI number1104883099
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedApril 26, 2006
Last updated in NPPESJanuary 18, 2012

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