Individual
MADISON GARTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, OTR
Contact information
Practice address
111 COLONY CROSSING WAY STE 250, MADISON, MS 39110-6832
(601) 326-6401
(601) 326-6405
Mailing address
PO BOX 4105, PORTLAND, OR 97208-4105
(866) 907-1068
(425) 917-9141
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
225X00000X
Occupational Therapist
109715
AK
225X00000X
Occupational Therapist
Primary
OT-3913
MS
Other
Enumeration date
10/22/2014
Last updated
03/28/2022
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