Individual
MADISON GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 LIBRARY BLVD, GREENWOOD, IN 46142-1567
(317) 881-9923
Mailing address
109 E CHESTNUT ST, BRAZIL, IN 47834-1703
(812) 605-2889
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/23/2018
Last updated
12/23/2018
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