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

Shannon Wallace

Individual provider Physical Therapy Assistant · NPI 1437707452

Shannon Wallace is a Physical Therapy Assistant in White Pine, Tennessee. Licensed in Tennessee. Registered with an NPI since 2019.

Licensed in
TN
In the registry since
2019

Practice location Address checks out

3108 Circle Dr
White Pine, TN 37890-3306
Phone: (865) 674-7454
Show map & directions

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

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 7143 (TN)

Record details

NPI number1437707452
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 3, 2019
Last updated in NPPESSeptember 3, 2019
Mailing addressPo Box 150, Lima, OH 45802-0150