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General NPI Number Information
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NPI Number | 1629526611
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Entity Type | Individual
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Provider Name | NATHAN MADAY
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Gender | Male
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 401 W MOHAWK DR STE 100
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City | TOMAHAWK
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State | WI
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Zip | 54487-2273
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Country | US
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Telephone | 715-453-7700
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Fax |
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Provider Business Mailing Address
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Address Line | N10640 N PINE RD
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City | TOMAHAWK
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State | WI
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Zip | 54487-9181
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Country | US
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Telephone | 715-966-5955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2478-19
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 17365-24
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License Number State | WI
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