# VIA PHYSICAL THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437963212
- **Authorized official:** MATTHEW ELLISON DPT (OWNER)
- **Authorized official phone:** (845) 453-4004

## Contact information

- **Practice address:** 2114 WINNEBAGO ST, MADISON, WI 53704-5319
- **Practice address phone:** (608) 218-4466
- **Mailing address:** 30 POWERS AVE, MADISON, WI 53714-1834
- **Mailing address phone:** (845) 453-4004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/03/2025
- **Last updated:** 02/03/2025