Organization
LITTLE RIVER MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY P MADISON (CEO)
(512) 446-4500
Entity
Organization
Contact information
Practice address
1717 SW H K DODGEN LOOP, SUITE 103, TEMPLE, TX 76502-1838
(254) 298-2599
Mailing address
1713 SW H K DODGEN LOOP, SUITE 122 AND 123, TEMPLE, TX 76502-1836
(254) 298-2599
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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