Provider Demographics
NPI:1710670211
Name:HOWELL, MADISON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:HOWELL
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 1:3712 ELLERTON DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-3667
Mailing Address - Country:US
Mailing Address - Phone:804-852-6004
Mailing Address - Fax:
Practice Address - Street 1:2000 WILKES RIDGE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7632
Practice Address - Country:US
Practice Address - Phone:804-877-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist