Provider Demographics
NPI:1497146575
Name:ALTMAN, MADELYN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MADELYN
Middle Name:
Last Name:ALTMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 N 79TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8979
Mailing Address - Country:US
Mailing Address - Phone:720-572-5236
Mailing Address - Fax:
Practice Address - Street 1:6800 N 79TH ST STE 202
Practice Address - Street 2:
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80503-8979
Practice Address - Country:US
Practice Address - Phone:720-572-5236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty