| Provider / Organization | NPI | Date Certified |
|---|---|---|
| WHITLEY MADISON | 1558099796 | 2024-02-02 |
Whitley Madison is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1558099796. Registration indicates Whitley Madison is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapist (Physical Therapist, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Whitley Madison PT, DPT |
| Practice Office Address | 2-22 BANTA PL FAIR LAWN, NJ US |
| Practice Office Telephone | 2015098600 |
| Mailing Address | 2-22 BANTA PL FAIR LAWN, NJ 074103058 US |
| Business Telephone | 2015098600 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1125 N College Ave # 100 | Fayetteville, AR 727031908 | 4797138630 / 4797138639 |
| Code | Practice | License No State |
|---|---|---|
| 225100000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist Physical Therapist Speech/Occupational/Physical Therapy/Chiropractor Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | PT5159
AR |