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

Mrs. Laurie Ann Wallace, MPT, ATC

Individual provider Physical Therapist · NPI 1770704306

Mrs. Laurie Ann Wallace, MPT, ATC is a Physical Therapist in Burlingame, California. Practices as a sole proprietor and works from 2 locations. Licensed in California and Florida.

Licensed in
CA, FL
In the registry since
2007
Specialties on file
3
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

130 Loma Vista Dr
Burlingame, CA 94010
Phone: (772) 321-4992
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 438 Wisnom Ave, San Mateo, CA 94401-2422 — (772) 321-4992

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 42268 (CA)
Physical Therapist Taxonomy 225100000X · Licence PT18527 (FL)
Athletic Trainer Taxonomy 2255A2300X · Licence AL617 (FL)

Record details

NPI number1770704306
Entity typeIndividual (Type 1)
GenderFemale
Credentials MPT , ATC
Sole proprietorYes
NPI enumeratedMay 1, 2007
Last updated in NPPESFebruary 27, 2019

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