Individual
MRS. MADELYN ARCHIBALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12228 ROSEVILLE DR, RANCHO CUCAMONGA, CA 91739-2438
(909) 899-5053
Mailing address
12228 ROSEVILLE DR, RANCHO CUCAMONGA, CA 91739-2438
(909) 899-5053
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
N5616932
CA
Other
Enumeration date
02/02/2011
Last updated
02/02/2011
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