Provider Demographics
NPI:1487951372
Name:LINSTER, MADISON (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:MADISON
Middle Name:
Last Name:LINSTER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16879 W WINDERMERE WAY
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-6811
Mailing Address - Country:US
Mailing Address - Phone:605-431-9369
Mailing Address - Fax:
Practice Address - Street 1:16428 E KINGSTREE BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-5440
Practice Address - Country:US
Practice Address - Phone:605-431-9369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4755225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist