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

Kimberly Wallace, MPT

Individual provider Physical Therapist · NPI 1033457791

Kimberly Wallace, MPT is a Physical Therapist in Private Practice in Philadelphia, Pennsylvania. Qualified in 2007, 19 years ago. Practices as a sole proprietor. Licensed in Pennsylvania.

Years since qualifying
19
Licensed in
PA
In the registry since
2013
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

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Practice location Address checks out

421 W School House Ln Unit 2
Philadelphia, PA 19144-4557
Phone: (973) 477-1421
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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 PT019083 (PA)

Record details

NPI number1033457791
Entity typeIndividual (Type 1)
GenderFemale
Credentials MPT
Sole proprietorYes
NPI enumeratedJanuary 30, 2013
Last updated in NPPESJanuary 30, 2013

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Not indicated

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