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

Individual provider Physical Therapist · NPI 1568420354

Ryan James Wallace, PT, DPT, OCS, MTC is a Physical Therapist in Bonita Springs, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
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

25241 Elementary Way Ste 200
Bonita Springs, FL 34135-7883
Phone: (239) 947-4184
Fax: (239) 947-4171
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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 PT 18604 (FL)

Record details

NPI number1568420354
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT , OCS , MTC
Sole proprietorNo
NPI enumeratedMay 2, 2006
Last updated in NPPESMay 12, 2015

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