Healthcare Provider Details

I. General information

NPI: 1871266726
Provider Name (Legal Business Name): MADISON M SCHEPPKE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14313 290TH AVE
NEW AUBURN WI
54757-5197
US

IV. Provider business mailing address

1200 OAKLEAF WAY STE B
ALTOONA WI
54720-2245
US

V. Phone/Fax

Practice location:
  • Phone: 715-491-8255
  • Fax:
Mailing address:
  • Phone: 715-839-9266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15553-24
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: