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General NPI Number Information
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NPI Number | 1912874173
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Entity Type | Individual
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Provider Name | MADISON CAROLINE IANNOTTA
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Gender | Female
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 230 N MAPLE AVE STE G2
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City | MARLTON
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State | NJ
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Zip | 08053-9415
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Country | US
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Telephone | 856-983-5422
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Fax |
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Provider Business Mailing Address
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Address Line | 38 ALBANY RD
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City | MARLTON
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State | NJ
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Zip | 08053-3516
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00815600
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License Number State | NJ
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