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

Individual provider Athletic Trainer · NPI 1568585362

MS. Eileen Wallace, ATC, PTA is an Athletic Trainer in Long Branch, New Jersey. Practices as a sole proprietor. Licensed in New Jersey.

Licensed in
NJ
In the registry since
2007
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

10 Arthur Ave
Long Branch, NJ 07740-6402
Phone: (732) 222-3839
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 25MT00040000 (NJ)

Record details

NPI number1568585362
Entity typeIndividual (Type 1)
GenderFemale
Credentials ATC , PTA
Sole proprietorYes
NPI enumeratedApril 8, 2007
Last updated in NPPESJuly 21, 2022
Mailing address10 Arthur Ave, Long Branch, NJ 07740-6402

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