Individual
TRAVIS S MADIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
405 E. EXCELSIOR, VINITA, OK 74301
(918) 256-6476
(918) 256-3628
Mailing address
405 E. EXCELSIOR, VINITA, OK 74301
(918) 256-6476
(918) 256-3628
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0036797
OK
Other
Enumeration date
04/27/2007
Last updated
07/08/2007
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