Individual
AMANDA ELIZABETH MADSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1001 E 17TH ST, BLOOMINGTON, IN 47408-1590
(507) 272-7452
Mailing address
100 WARTBURG BLVD, WAVERLY, IA 50677-2215
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000808
IA
Other
Enumeration date
08/26/2009
Last updated
05/04/2020
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