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Individual

MISS MADISON LEIGH LISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2601 E EVESHAM RD, VOORHEES, NJ 08043-9509
(856) 596-1113
Mailing address
1909 LOMBARD ST, PHILADELPHIA, PA 19146-1410
(610) 585-5643

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
06/12/2017
Last updated
06/12/2017
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