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General NPI Number Information
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NPI Number | 1124917331
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Entity Type | Organization
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Legal Business Name | JOSH MADONICK PHYSICAL THERAPY
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 1320 INDUSTRIAL AVE STE L
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City | PETALUMA
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State | CA
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Zip | 94952-6522
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Country | US
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Telephone | 707-238-2483
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Fax |
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Provider Business Mailing Address
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Address Line | 1593 RAINIER AVE
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City | PETALUMA
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State | CA
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Zip | 94954-1568
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSH MADONICK
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Credential |
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Telephone | 925-918-0470
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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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