Provider Demographics
NPI:1023633021
Name:LOVEJOY, MADISON JAYNE (DPT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:JAYNE
Last Name:LOVEJOY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:JAYNE
Other - Last Name:MARQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:460 POLARIS PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-6092
Mailing Address - Country:US
Mailing Address - Phone:614-259-0906
Mailing Address - Fax:
Practice Address - Street 1:460 POLARIS PKWY STE 150
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6092
Practice Address - Country:US
Practice Address - Phone:614-259-0906
Practice Address - Fax:614-259-0618
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018649225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist