Provider Demographics
NPI:1760172639
Name:MATZKE, MADISYN (OTRL)
Entity type:Individual
Prefix:
First Name:MADISYN
Middle Name:
Last Name:MATZKE
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:MADISYN
Other - Middle Name:
Other - Last Name:WIRTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5815 BAY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2542
Mailing Address - Country:US
Mailing Address - Phone:989-799-6885
Mailing Address - Fax:989-799-6890
Practice Address - Street 1:5815 BAY RD STE 400
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2542
Practice Address - Country:US
Practice Address - Phone:989-799-6885
Practice Address - Fax:989-799-6890
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist