Individual
MADISYN D MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
860 RANDOLPH ST, GLASGOW, MO 65254-1277
(660) 338-2012
Mailing address
102 GLEN EDEN DR, GLASGOW, MO 65254-9502
(660) 672-9664
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2023039891
MO
225200000X
Physical Therapy Assistant
Primary
2021043996
MO
Other
Enumeration date
11/13/2023
Last updated
07/29/2025
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