Healthcare Provider Details

I. General information

NPI: 1801377015
Provider Name (Legal Business Name): MADISON OLBERDING PT, DPT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2018
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 CHESTNUT ST
GREENVILLE OH
45331-1312
US

IV. Provider business mailing address

135 FOX HARBOR DR
TROY OH
45373-1088
US

V. Phone/Fax

Practice location:
  • Phone: 937-547-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: