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1821717679
MADISON LEE JAMES
CENTERVILLE, UT
NPI
1821717679
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: UT 12839605-3101)
Enumeration Date
2022-08-24
Last Update Date
2022-08-24
Business Address
MADISON LEE JAMES
692 W 2075 N
CENTERVILLE, UT 84014-2611
Phone number: 801-638-7595
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Mailing Address
MADISON LEE JAMES
692 W 2075 N
CENTERVILLE, UT 84014-2611
Phone number: 801-638-7595
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