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NPI Code Detail

MEDICARE: KARLENE MARIE MADILL

MEDICARE: KARLENE MARIE MADILL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist6761MN

General Provider Information

NPI Number : 1609936723
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARLENE MARIE MADILL
Provider Business Mailing Address
First Line : 109 COURT AVE S
Second Line :
City : SANDSTONE
State : MN
Zip : 55072-5120
Country : US
Telephone Number : 320-245-2211
Fax Number :
Provider Business Practice Location Address
First Line : 109 COURT AVE S
Second Line :
City : SANDSTONE
State : MN
Zip : 55072-5120
Country : US
Telephone Number : 320-245-2211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 07/08/2007

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Directions to “ KARLENE MARIE MADILL ” Practice Location

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