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NPI Code Detail

MEDICARE: MADELINE WYATT PT

MEDICARE: MADELINE WYATT PT
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
1225100000XPhysical Therapist16304TN

General Provider Information

NPI Number : 1427853993
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE WYATT PT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-497-0005
Fax Number :
Provider Business Practice Location Address
First Line : 115 CUMBERLAND PLZ
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-4292
Country : US
Telephone Number : 931-787-1244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2025
Last Update Date : 12/09/2025

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Directions to “ MADELINE WYATT PT” Practice Location

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