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

Dr. Matthew David Mallory, DPT

Individual provider Physical Therapist · NPI 1659835825

Dr. Matthew David Mallory, DPT is a Physical Therapist in Private Practice in Grandville, Michigan. Qualified in 2017, 9 years ago. Practices with Hulst Jepsen Physical Therapy Inc, a 133-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
9
Licensed in
TN
In the registry since
2019
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

5570 Wilson Ave SW Ste A
Grandville, MI 49418
Phone: (616) 855-1495
Fax: (616) 855-1496
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 11564 (TN)

Record details

NPI number1659835825
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedJanuary 22, 2019
Last updated in NPPESAugust 2, 2021
Certification dateAugust 2, 2021
Mailing addressPo Box 30516, Dept 5300, Lansing, MI 48909

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Hulst Jepsen Physical Therapy Inc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Grandville