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

Madisen Wallace, PT, DPT

Individual provider Physical Therapist · NPI 1821847153

Madisen Wallace, PT, DPT is a Physical Therapist in Private Practice in Lima, Ohio. Qualified in 2024, 2 years ago. Practices with Back on Track Therapy and Wellness, LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
2
Licensed in
OH
In the registry since
2024
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

3477 S Dixie Hwy
Lima, OH 45804-3706
Phone: (567) 356-4385
Fax: (419) 738-8002
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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 PT021082 (OH)

Record details

NPI number1821847153
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedMay 17, 2024
Last updated in NPPESMay 18, 2024
Certification dateMay 18, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Back On Track Therapy And Wellness, Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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