Individual
BRENDA ELISA MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1251 W 96TH ST, #N, INDIANAPOLIS, IN 46260-1181
(317) 377-6400
(317) 377-1668
Mailing address
6114 PILLORY DR, INDIANAPOLIS, IN 46254-5054
(317) 377-6400
(317) 377-1668
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06000862A
IN
Other
Enumeration date
01/30/2008
Last updated
01/30/2008
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