Provider Information for 1902251630
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MADELEINE MCCONNELL
Sex: Female
NPI: 1902251630
Last Updated: 2016-05-02
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1902251630 | ||||||||||||
| Enumeration Date | 2016-05-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1802 E NICHOLSON HILL RD OSSINEKE, MI 49766-9701 United States Phone: 989-464-1386 | Fax: | ||||||||||||
| Primary Practice Address | 1802 E NICHOLSON HILL RD OSSINEKE, MI 49766-9701 United States Phone: 989-464-1386 | Fax: | ||||||||||||
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