Individual
MADISON GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6780 W THUNDERBIRD RD # A101, PEORIA, AZ 85381-5049
(602) 843-1991
Mailing address
7700 W ASPERA BLVD APT 2002, GLENDALE, AZ 85308-7924
(435) 669-0313
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10495
AZ
Other
Enumeration date
07/05/2024
Last updated
07/05/2024
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