Individual
MADISON IMBODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6235 MONROE ST, SYLVANIA, OH 43560-1427
(419) 885-4738
Mailing address
6810 WYNNBROOK CT, HOLLAND, OH 43528-9623
(937) 403-4479
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03442197
OH
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
03442197
OH
Other
Enumeration date
11/04/2022
Last updated
06/18/2026
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