MEDICARE: WHOLE HEALTH PHYSICAL THERAPY LLC MARY A MADDEN SOLE MBR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1205781879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLE HEALTH PHYSICAL THERAPY LLC MARY A MADDEN SOLE MBR

Provider Business Mailing Address
First Line	:	2843 W COTTONWILLOW WAY
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72704-5136
Country	:	US
Telephone Number	:	479-349-6119
Fax Number	:

Provider Business Practice Location Address
First Line	:	2843 W COTTONWILLOW WAY
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72704-5136
Country	:	US
Telephone Number	:	615-445-9445
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARY ASHTYN MADDEN
Credential	:	PT, DPT
Telephone Number	:	479-349-6119

Provider Enumeration Date	:	02/28/2026
Last Update Date	:	03/02/2026

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