Individual
MADISON LANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W MAIN ST, BLUE MOUNTAIN, MS 38610-9220
(662) 401-3114
Mailing address
1510 ENDVILLE RD, BELDEN, MS 38826-9131
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1116
MS
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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