Provider Demographics
NPI:1487048344
Name:MADDUX, JOANNE (OTR)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:
Last Name:MADDUX
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5553 N COUNTY ROAD 10 E
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-7770
Mailing Address - Country:US
Mailing Address - Phone:812-525-0734
Mailing Address - Fax:
Practice Address - Street 1:702 ELM ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-3317
Practice Address - Country:US
Practice Address - Phone:812-265-3448
Practice Address - Fax:812-265-3459
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000793A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist