Individual
MADISON MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT, ATC
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(586) 817-3679
Mailing address
26592 AUTUMN LAKE DR, CHESTERFIELD, MI 48051-1989
(586) 817-3679
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002247
MI
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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