Individual
MADISON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1112 JAMES AVE APT A, WACO, TX 76706-2128
(214) 929-7545
Mailing address
1112 JAMES AVE APT A, WACO, TX 76706-2128
(214) 929-7545
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/07/2022
Last updated
09/11/2025
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