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General NPI Number Information
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NPI Number | 1962387092
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Entity Type | Individual
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Provider Name | MADISON LYNN SCOTT CERTBBM
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Gender | Female
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 2350 WASHTENAW AVE STE 3
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City | ANN ARBOR
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State | MI
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Zip | 48104-4526
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Country | US
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Telephone | 810-279-0880
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Fax | 810-776-3038
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Provider Business Mailing Address
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Address Line | 1750 GRAY RD
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City | HOWELL
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State | MI
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Zip | 48843-9104
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Country | US
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Telephone | 810-287-3331
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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