Organization
MADELYN AND MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS GREEN JR. (PRESIDENT)
(310) 739-1601
Entity
Organization
Contact information
Practice address
202 N CEDAR AVE STE 1, OWATONNA, MN 55060-2306
(310) 739-1601
Mailing address
202 N CEDAR AVE STE 1, OWATONNA, MN 55060-2306
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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