Individual
MRS. MADILYN SUE SLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1118 N RECKER RD, 109, MESA, AZ 85205-5504
(480) 833-2778
(480) 833-0232
Mailing address
1118 N RECKER RD, 109, MESA, AZ 85205-5504
(480) 833-2778
(480) 833-0232
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6903
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68-0659242
TAX ID
AZ
01
—
6903
LICENSE
AZ
Enumeration date
07/03/2007
Last updated
11/03/2014
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