Provider Demographics
NPI:1649628090
Name:PROULX, MARGARET E (PT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:E
Last Name:PROULX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W BELTLINE HWY STE 601
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2309
Mailing Address - Country:US
Mailing Address - Phone:608-294-6464
Mailing Address - Fax:608-288-6495
Practice Address - Street 1:2501 W BELTLINE HWY STE 601
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-2309
Practice Address - Country:US
Practice Address - Phone:608-294-6464
Practice Address - Fax:608-288-6495
Is Sole Proprietor?:No
Enumeration Date:2016-05-26
Last Update Date:2020-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13409-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist