Healthcare Provider Details

I. General information

NPI: 1407454630
Provider Name (Legal Business Name): MADISON CAROLINE LAMASTER PT,DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2020
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10390 N LA CANADA DR STE 110
ORO VALLEY AZ
85737-7273
US

IV. Provider business mailing address

5301 E GRANT RD
TUCSON AZ
85712-2805
US

V. Phone/Fax

Practice location:
  • Phone: 520-420-2110
  • Fax: 520-420-2111
Mailing address:
  • Phone: 520-327-5461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1333693
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number034710
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: