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

Garrett Wallace

Individual provider Physical Therapist · NPI 1306339262

Garrett Wallace is a Physical Therapist in Private Practice in Summit, Mississippi. Qualified in 2018, 8 years ago. Practices with Professional Rehab Associates, a 7-clinician group and accepts Medicare assignment.

Years since qualifying
8
In the registry since
2018

Practice location Address checks out

4109 Highway 98 W
Summit, MS 39666-9132
Phone: (601) 276-3909
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1306339262
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 14, 2018
Last updated in NPPESJune 14, 2018
Mailing address4109 Highway 98 W, Summit, MS 39666-9132

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Professional Rehab Associates — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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