Provider Demographics
NPI:1477353076
Name:SCHULTZ, MADISON LYNN (DPT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:LYNN
Last Name:SCHULTZ
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:PO BOX 5105
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-5100
Mailing Address - Country:US
Mailing Address - Phone:103-323-8289
Mailing Address - Fax:
Practice Address - Street 1:7459 HIGH MARKET ST
Practice Address - Street 2:SUITE 6
Practice Address - City:SUNSET BEACH
Practice Address - State:NC
Practice Address - Zip Code:28468
Practice Address - Country:US
Practice Address - Phone:910-332-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13483225100000X
NCP23917225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist