Individual
MADISON PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 DEAN DR, GARDENDALE, AL 35071-2763
(205) 631-8709
Mailing address
7568 OLD BAGLEY RD, EMPIRE, AL 35063-5110
(205) 910-0306
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4884
AL
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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