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General NPI Number Information
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NPI Number | 1063608495
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Entity Type | Organization
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Legal Business Name | MADISON PHYSICAL THERAPY ASSOCIATES, LLC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 370 HIGHLAND PARK DR STE 1
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City | RICHMOND
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State | KY
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Zip | 40475-3546
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Country | US
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Telephone | 859-625-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 370 HIGHLAND PARK DR STE 1
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City | RICHMOND
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State | KY
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Zip | 40475-3546
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Country | US
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Telephone | 859-625-9700
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MARGARET S. GAGNON
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Credential | P.T.
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Telephone | 859-625-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 0000
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License Number State | KY
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