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General NPI Number Information
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NPI Number | 1730053554
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Entity Type | Individual
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Provider Name | MADISON JANE HOLLIDAY-WARD
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Gender | Female
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 1505 WATERFORD PKWY
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City | SAINT JOHNS
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State | MI
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Zip | 48879-9630
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Country | US
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Telephone | 989-292-3572
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Fax |
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Provider Business Mailing Address
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Address Line | 3228 W FILLMORE RD
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City | ITHACA
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State | MI
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Zip | 48847-9606
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Country | US
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Telephone |
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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 | 374700000X
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Taxonomy Name | Technician
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License Number |
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License Number State |
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