MEDICARE: MS. ASHLEY MARIE MADDERN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	25854	FL
2	225100000X	Physical Therapist	8622	MN

General Provider Information

NPI Number	:	1356641575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ASHLEY MARIE MADDERN DPT

Provider Business Mailing Address
First Line	:	9720 ROUNDSTONE CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33967-5157
Country	:	US
Telephone Number	:	218-248-9524
Fax Number	:

Provider Business Practice Location Address
First Line	:	848 1ST AVE N STE 120
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-6093
Country	:	US
Telephone Number	:	239-384-5952
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2010
Last Update Date	:	01/02/2026

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