MEDICARE: MADISON MACKENZIE WESTRICH PT, DPT

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	225100000X	Physical Therapist	13107	MN
2	225100000X	Physical Therapist	238419	AK

General Provider Information

NPI Number	:	1871275982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON MACKENZIE WESTRICH PT, DPT

Provider Business Mailing Address
First Line	:	3765 E BLUE LUPINE DR STE E
Second Line	:
City	:	WASILLA
State	:	AK
Zip	:	99654-8417
Country	:	US
Telephone Number	:	907-332-0021
Fax Number	:	907-373-9464

Provider Business Practice Location Address
First Line	:	7985 E 16TH AVE STE 100
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99504-2896
Country	:	US
Telephone Number	:	907-332-0021
Fax Number	:	907-373-9464

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2023
Last Update Date	:	08/27/2025

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