Individual
DR. LEIF MADSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, ATC
Contact information
Practice address
3044 E MATTATHA DR, BLOOMINGTON, IN 47401-4740
(608) 215-3688
Mailing address
3044 E MATTATHA DR, BLOOMINGTON, IN 47401-9413
(608) 215-3688
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002883A
IN
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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