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

Godiza Marie Wallace

Individual provider Physical Therapist · NPI 1083556591

Godiza Marie Wallace is a Physical Therapist in Private Practice in Chevy Chase, Maryland. Qualified in 2003, 23 years ago. Licensed in Maryland.

Years since qualifying
23
Licensed in
MD
In the registry since
2026
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Practice location Address checks out

5425 Wisconsin Ave Ste 600
Chevy Chase, MD 20815-3588
Phone: (866) 525-3175
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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 24366 (MD)

Record details

NPI number1083556591
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 6, 2026
Last updated in NPPESJuly 2, 2026
Certification dateJuly 2, 2026

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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