Provider Demographics
NPI:1639932122
Name:SWARTOUT, MADISON ALEXIS (DPT)
Entity Type:Individual
Prefix:MS
First Name:MADISON
Middle Name:ALEXIS
Last Name:SWARTOUT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 LANING ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-1603
Mailing Address - Country:US
Mailing Address - Phone:203-441-4261
Mailing Address - Fax:860-736-5013
Practice Address - Street 1:292 SPIELMAN HWY
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06013-1727
Practice Address - Country:US
Practice Address - Phone:860-404-2924
Practice Address - Fax:860-404-2933
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14336225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist