Individual
KEITH MADISON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12114 IMPERIAL AVE, CLEVELAND, OH 44120-3115
(216) 678-5041
Mailing address
12114 IMPERIAL AVE, CLEVELAND, OH 44120-3115
(216) 678-5041
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
TR000277
OH
Other
Enumeration date
03/06/2025
Last updated
03/06/2025
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