MR. ROBERT JASON WALLACE ATC
NPI 1972325603
Specialist/Technologist - Athletic Trainer in Detroit, MI

Active since October 24, 2024
261 MACK AVE, DETROIT, MI 48201(313) 966-7246 Get Directions Write a Review

NPPES record last updated: October 24, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Robert Jason Wallace Atc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. ROBERT JASON WALLACE ATC (NPI 1972325603) is an individual athletic trainer provider in Detroit, Michigan, licensed in Michigan (2601001545) and active in the NPI registry since October 2024.

NPPES Registry Identity

NPI1972325603
Entity TypeIndividualMale
Primary Taxonomy2255A2300X
Provider Legal NameMR. ROBERT JASON WALLACECredential: ATC
Location Address261 MACK AVEDetroit, MI 48201-2417
Mailing Address8946 San Marco BlvdSterling Heights, MI 48313-4866 · (586) 488-6467
Sole ProprietorNo
Enumeration DateOctober 24, 2024
NPPES CertifiedOctober 24, 2024
NPI 1972325603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialist/Technologist · Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2255A2300X
License Licensed in MI · 2601001545
Definition

Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor's degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

261 MACK AVE, Detroit, MI 48201

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist/Technologist (Athletic Trainer)
261 MACK AVE
DETROIT, MI 48201
Physician Assistant
261 MACK AVE
DETROIT, MI 48201
Rehabilitation Hospital
261 MACK AVE
DETROIT, MI 48201
Counselor
261 MACK AVE
DETROIT, MI 48201
Clinic/Center (Rehabilitation)
261 MACK AVE
DETROIT, MI 48201
Specialist/Technologist (Athletic Trainer)
261 MACK AVE
DETROIT, MI 48201
Nurse Practitioner
261 MACK AVE
DETROIT, MI 48201
Student in an Organized Health Care Education/Training Program
261 MACK AVE
DETROIT, MI 48201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1972325603, enumerated as an "individual" on October 24, 2024.

The provider is located at 261 MACK AVE DETROIT, MI 48201 and the phone number is (313) 966-7246.

Specialist/Technologist with taxonomy code 2255A2300X and a focus in Athletic Trainer.