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

Mr. Michael Wallace, DPT

Individual provider Physical Therapist · NPI 1881368561

Mr. Michael Wallace, DPT is a Physical Therapist in Loganville, Georgia. Licensed in Georgia. Registered with an NPI since 2021.

Licensed in
GA
In the registry since
2021
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

3440 Highway 81
Loganville, GA 30052-9112
Phone: (770) 554-5009
Fax: (706) 546-8792
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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 PT015458 (GA)

Record details

NPI number1881368561
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedAugust 5, 2021
Last updated in NPPESMarch 11, 2024
Certification dateMarch 11, 2024
Mailing address1017 Crystal Brook Way, Monroe, GA 30655-7313

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