Provider Demographics
NPI:1871255547
Name:DOWNING, MADELYN JEAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MADELYN
Middle Name:JEAN
Last Name:DOWNING
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 1:4254 GRAND AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1912
Mailing Address - Country:US
Mailing Address - Phone:612-360-8680
Mailing Address - Fax:
Practice Address - Street 1:75 VIKING DR W STE 101
Practice Address - Street 2:
Practice Address - City:LITTLE CANADA
Practice Address - State:MN
Practice Address - Zip Code:55117-1778
Practice Address - Country:US
Practice Address - Phone:651-766-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist