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

Michell Wallace, PTA

Individual provider Physical Therapy Assistant · NPI 1043554413

Michell Wallace, PTA is a Physical Therapy Assistant in Trumbull, Connecticut. Licensed in Connecticut. Registered with an NPI since 2012.

Licensed in
CT
In the registry since
2012
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

6448 Main St
Trumbull, CT 06611-2075
Phone: (203) 268-6204
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 000988 (CT)

Record details

NPI number1043554413
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedNovember 24, 2012
Last updated in NPPESNovember 24, 2012
Mailing address2810 Old Town Rd, Bridgeport, CT 06606-1243

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