# EVOLUTION EXERCISE AND SPINE CENTER OF MADISON LLC

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

## Provider details

- **NPI number:** 1902848401
- **Authorized official:** MARY HALL M.P.T. (EMPLOYEE)
- **Authorized official phone:** (608) 662-0016

## Contact information

- **Practice address:** 376 JUNCTION RD, MADISON, WI 53717-2612
- **Practice address phone:** (608) 662-0016
- **Mailing address:** 376 JUNCTION RD, MADISON, WI 53717-2612
- **Mailing address phone:** (608) 662-0016

## Taxonomy

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

## Other

- **Enumeration date:** 06/11/2006
- **Last updated:** 04/08/2009