Individual
MADISON STRAIN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7726 HIGHWAY 165, COLUMBIA, LA 71418-3322
(318) 649-9826
Mailing address
239 SLAY RD, OLLA, LA 71465-6540
(318) 550-7841
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A09810
LA
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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