Individual
MADISON ROSKUSZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
141 E 12TH ST, DEVOS FIELDHOUSE, HOLLAND, MI 49423-3607
(616) 395-7098
Mailing address
26W340 THORNGATE LN, WINFIELD, IL 60190-2375
(630) 408-8853
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/10/2015
Last updated
03/10/2015
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