Individual
MADISON SIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6 STOCKBRIDGE DR, AVON, CT 06001-4415
(860) 810-3699
Mailing address
6 STOCKBRIDGE DR, AVON, CT 06001-4415
(860) 810-3699
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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