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

Mrs. Judy Lynn Wallis, PTA

Individual provider Physical Therapy Assistant · NPI 1356558324

Mrs. Judy Lynn Wallis, PTA is a Physical Therapy Assistant in Grand Rapids, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2007
Specialties on file
2
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Partly verified

Some contact details are missing from the federal record.

Marywood Health Center 111 Lakeside Dr NE
Grand Rapids, MI 49503
Phone: (616) 453-7715
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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
Physical Therapy Assistant Taxonomy 225200000X · Licence 5502000688 (MI)

Record details

NPI number1356558324
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedMay 17, 2007
Last updated in NPPESDecember 7, 2018

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