Individual
MADISON FABRIZIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 WESTWIND DR, MANHATTAN, KS 66503-2435
(785) 410-0168
Mailing address
1500 WESTWIND DR, MANHATTAN, KS 66503-2435
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-01154
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000026309
BOARD OF CERTIFICATION
KS
Enumeration date
11/04/2016
Last updated
11/04/2016
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