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

Keith Wallace

Individual provider Occupational Therapy Assistant · NPI 1831577337

Keith Wallace is an Occupational Therapy Assistant in Gilbert, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2015

Practice location Address checks out

4902 S Val Vista Dr Ste B102
Gilbert, AZ 85298-7325
Phone: (480) 855-8866
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 5853 (AZ)

Record details

NPI number1831577337
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 15, 2015
Last updated in NPPESMay 15, 2015
Mailing address9432 E Conquistadores Dr, Scottsdale, AZ 85255-4343

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