Provider Demographics
NPI:1124916028
Name:LYSAUGHT, MADISON MCKENZIE (DPT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MCKENZIE
Last Name:LYSAUGHT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 SW LANE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3201
Mailing Address - Country:US
Mailing Address - Phone:785-233-5500
Mailing Address - Fax:785-233-5512
Practice Address - Street 1:1601 SW LANE ST STE 101
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3201
Practice Address - Country:US
Practice Address - Phone:785-233-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-07943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist