Most Relevant Information
Provider Data
| NPI Number: | 1003486648 |
| Provider Name: | MADISON CARTER PEMBERTON PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PTH10384 |
Most Important Dates
| Enumeration Date: | 06/27/2021 |
| Last Updated: | 06/27/2021 |
Provider Practice Location
122 S WOODBURN DR
DOTHAN
AL
363051020
Practice Location Phone/Fax
| Phone: | 3344461425 |
| Fax: |
Provider Mailing Location
2413 HIGHWAY 77
CHIPLEY
FL
324285769
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |