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General NPI Number Information
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NPI Number | 1053873497
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Entity Type | Organization
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Legal Business Name | MADISON PEDIATRIC THERAPY
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 12512 ALUM SPRINGS RD
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City | CULPEPER
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State | VA
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Zip | 22701-5111
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Country | US
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Telephone | 703-434-1926
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Fax | 540-317-5200
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Provider Business Mailing Address
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Address Line | 12512 ALUM SPRINGS RD
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City | CULPEPER
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State | VA
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Zip | 22701-5111
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Country | US
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Telephone | 703-434-1926
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Fax |
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | MRS. ELIZABETH ASHLEY-ALLEN GEARY
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Credential | MOT OTR/L
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Telephone | 703-434-1926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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