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Organization
MADONNA COMPANY
Active
Organization
MADONNA COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. G ANDERSON S (REP)
(747) 256-4015
Entity
Organization
Contact information
Practice address
13746 VICTORY BLVD, VAN NUYS, CA 91401-6716
(747) 256-4015
Mailing address
506 N SPRING ST, #1330, LOS ANGELES, CA 90012
(747) 256-4015
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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