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

Grant Wallace, DPT

Individual provider Physical Therapist · NPI 1386514339

Grant Wallace, DPT is a Physical Therapist in Private Practice in Daytona Beach, Florida. Qualified in 2025, 1 year ago. Practices with Orthopaedic Clinic of Daytona Beach PA, a 48-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
1
Licensed in
FL
In the registry since
2025
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

1865 Lpga Blvd
Daytona Beach, FL 32117-7108
Phone: (386) 255-4596
Fax: (386) 258-3561
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 1890 Lpga Blvd Ste 240, Daytona Beach, FL 32117-7131 — (386) 255-4596
  • 17 Old Kings Rd, Palm Coast, FL 32137-8282 — (386) 255-4596
  • 1165 Dunlawton Ave Ste 102, Port Orange, FL 32127-2924 — (386) 255-4596

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT43773 (FL)

Record details

NPI number1386514339
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedNovember 6, 2025
Last updated in NPPESNovember 13, 2025
Certification dateNovember 13, 2025
Mailing address1865 Lpga Blvd, Daytona Beach, FL 32117-7108

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Orthopaedic Clinic Of Daytona Beach Pa — 48 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Daytona Beach