Individual
MADISON GRACE TARGGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2024 GRANNY SMITH PL, KENDALLVILLE, IN 46755-2874
(260) 582-9099
Mailing address
2024 GRANNY SMITH PL, KENDALLVILLE, IN 46755-2874
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IN
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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