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General NPI Number Information
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NPI Number | 1386484657
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Entity Type | Individual
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Provider Name | ALYSSA MARIE MADINGER
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Gender | Female
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Dates
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Enumeration Date | 05/25/2024
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Last Update Date | 05/25/2024
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Provider Practice Location Address
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Address Line | 2687 N MEMORIAL DR
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City | LANCASTER
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State | OH
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Zip | 43130-1670
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Country | US
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Telephone | 740-687-0530
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Fax | 740-687-0588
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Provider Business Mailing Address
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Address Line | 6581 HARSHMAN CT
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-5019
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Country | US
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Telephone | 520-273-3611
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | OP.017751-S
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License Number State | OH
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