Individual
MADALYN R DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-4980
(262) 245-2248
Mailing address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-4980
(262) 245-2248
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14716-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100089556
—
WI
Enumeration date
06/17/2019
Last updated
09/18/2025
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