Individual
MADISON WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
432 RAILROAD ST, LOCK HAVEN, PA 17745-1135
(570) 484-3978
Mailing address
361 DL&W AVE APT 202, DANVILLE, PA 17821
(570) 394-4134
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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