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Individual

EVAN MADSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2813 INDUSTRIAL PARK RD, SUITE 3, MIFFLINTOWN, PA 17059-9078
(717) 436-6042
(717) 436-6264
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT024287
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1030122400001
PA
Enumeration date
03/04/2015
Last updated
02/28/2019
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