Individual
MR. BROOK WADE MADLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
19 MINER ST, CANTON, NY 13617-1231
(315) 261-4182
Mailing address
130 DAYTON RD, POTSDAM, NY 13676-3269
(315) 261-4182
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
047068
NY
Other
Enumeration date
11/30/2007
Last updated
10/08/2008
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