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Search › Tennessee › Occupational Therapy Assistant

Blake Wallace

NPI 1821617663 · on the registry since 2020 · sole proprietor

Practice

Address
7820 Walking Horse Cir
Germantown, TN 38138
Phone
(901) 752-2500
Organisation at this address
The Village Doctor, Llc
The Village At Germantown Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
15

Registry record

Primary taxonomy
Occupational Therapy Assistant
224Z00000X
Licence states on file
MS
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-04-12

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 Tennessee