Individual
MADISON ALYSE KOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1428 S LAPEER RD, LAKE ORION, MI 48360-1437
(248) 693-0543
Mailing address
1426 S LAPEER RD, LAKE ORION, MI 48360
(248) 693-0543
(248) 693-3683
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011346
MI
Other
Enumeration date
09/09/2022
Last updated
12/19/2022
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