Provider Demographics
NPI:1982459756
Name:GARRETT, MADISON (DPT)
Entity type:Individual
Prefix:MS
First Name:MADISON
Middle Name:
Last Name:GARRETT
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 1:500 RIVER HIGHLANDS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7015
Mailing Address - Country:US
Mailing Address - Phone:985-327-2355
Mailing Address - Fax:985-893-2846
Practice Address - Street 1:5931 BULLARD AVE STE 6
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-2817
Practice Address - Country:US
Practice Address - Phone:504-243-6777
Practice Address - Fax:504-243-6773
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist