Healthcare Provider Details
I. General information
NPI: 1841007309
Provider Name (Legal Business Name): MADISON AVERY ZIEGLER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/17/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1031 SW FLEMING CT
TOPEKA KS
66604-1851
US
IV. Provider business mailing address
1334 SW OVERLOOK DR APT 11
TOPEKA KS
66615-1486
US
V. Phone/Fax
- Phone: 785-440-0500
- Fax:
- Phone: 620-366-0844
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251G0304X |
| Taxonomy | Geriatric Physical Therapist |
| License Number | 11-07118 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: