Individual
MRS. MADISON BOUTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSAT, ATC, LAT
Contact information
Practice address
397 N 600 E, MILL CREEK, IN 46365-9607
(219) 851-6845
Mailing address
397 N 600 E, MILL CREEK, IN 46365-9607
(219) 851-6845
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003731A
IN
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
03/07/2022
Last updated
05/30/2023
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