Individual
MISS TONYA RAE MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
634 AVONDALE ST, EAST LIVERPOOL, OH 43920-3305
(681) 216-5419
Mailing address
634 AVONDALE ST, EAST LIVERPOOL, OH 43920-3305
(681) 216-5419
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
Other
Enumeration date
04/21/2023
Last updated
04/21/2023
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