Individual
MR. KENNETH O MADLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CCC-A
Contact information
Practice address
115 S MAIN ST, WINCHESTER, IN 47394-1822
(765) 584-4327
(765) 584-3677
Mailing address
115 S MAIN ST, WINCHESTER, IN 47394-1822
(765) 584-4327
(765) 584-3677
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
23002191A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000294346
ANTHEM BCBS PROV NUMBER
IN
05
—
200443140
—
IN
Enumeration date
01/16/2007
Last updated
07/09/2007
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