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General NPI Number Information
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NPI Number | 1083568224
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Entity Type | Organization
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Legal Business Name | ROOTED PELVIC HEALTH PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 159 S FAIR OAKS AVE
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City | MADISON
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State | WI
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Zip | 53704-5820
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Country | US
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Telephone | 608-285-2599
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Fax |
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Provider Business Mailing Address
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Address Line | 525 CLEMONS AVE
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City | MADISON
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State | WI
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Zip | 53704-5505
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Country | US
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Telephone | 608-957-9964
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MICHELLE SHIVELY
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Credential | PT, DPT
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Telephone | 608-957-9964
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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 |
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License Number State |
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