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

Michell Wallace, PTA

Individual provider Physical Therapy Assistant · NPI 1043554413

Michell Wallace, PTA is a Physical Therapy Assistant in Trumbull, Connecticut. Licensed in Connecticut. Registered with an NPI since 2012.

Licensed in
CT
In the registry since
2012
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

6448 Main St
Trumbull, CT 06611-2075
Phone: (203) 268-6204
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 000988 (CT)

Record details

NPI number1043554413
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorNo
NPI enumeratedNovember 24, 2012
Last updated in NPPESNovember 24, 2012

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