Individual
MARC C MADDOX
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
600 E 5TH ST, FULTON, MO 65251-1753
(573) 592-2623
Mailing address
4920 FORUM BLVD, COLUMBIA, MO 65203-5648
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01196
MO
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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