Healthcare Provider Details

I. General information

NPI: 1235975491
Provider Name (Legal Business Name): MADISON HILL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADISON NOEL PT, DPT

II. Dates (important events)

Enumeration Date: 07/06/2024
Last Update Date: 07/06/2024
Certification Date: 07/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MARKET ST NE
OLYMPIA WA
98501-1008
US

IV. Provider business mailing address

7310 E 64TH PL
TULSA OK
74133-7511
US

V. Phone/Fax

Practice location:
  • Phone: 360-754-7085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6072
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: