Individual
MARY LOU MADRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
34 CITATION DR, LATHAM, NY 12110-1950
(518) 785-5968
Mailing address
34 CITATION DR, LATHAM, NY 12110-1950
(518) 785-5968
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
243340
NY
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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