Individual
MRS. MADILYN SUE SLADE
Active
Individual
MRS. MADILYN SUE SLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
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
Update your record
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