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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790456614

Kassy Arlene Wallace, PT, DPT is a Physical Therapist in Private Practice in Cadillac, Michigan. Qualified in 2022, 4 years ago. Practices with Dynamic Physical Therapy Inc, an 11-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
4
Licensed in
MI
In the registry since
2021
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

8872 Professional Dr Ste C
Cadillac, MI 49601-8482
Phone: (231) 876-0010
Fax: (231) 876-0241
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4040 Beacon St, Kingsley, MI 49649-9548 — (231) 263-1350

Specialties & licences

Orthopedic Physical Therapist (primary) Taxonomy 2251X0800X · Licence 5501301778 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1790456614
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedSeptember 21, 2021
Last updated in NPPESAugust 18, 2022
Certification dateAugust 18, 2022

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Dynamic Physical Therapy Inc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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