SearchOklahoma2251E1200X

Randall Wallace, P.T

NPI 1497820252 · on the registry since 2006

Practice

Address
409 E. California Ave.
Oaklahoma City, OK 73104
Phone
(405) 879-6766
Fax
(405) 879-3493

Registry record

Primary taxonomy
2251E1200X
2251E1200X
Also registered as
225100000X
Licence states on file
OK
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-09-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma