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General NPI Number Information
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NPI Number | 1508681495
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Entity Type | Individual
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Provider Name | MADISEN BRYAN DC
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 3313 MEMORIAL PKWY SW STE 121
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5315
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Country | US
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Telephone | 256-804-9059
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Fax |
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Provider Business Mailing Address
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Address Line | 102 SHEARWATER DR
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City | MERIDIANVILLE
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State | AL
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Zip | 35759-3108
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Country | US
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Telephone | 724-831-7335
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2875
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License Number State | AL
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