Madison Sides
Specialist/Technologist, Athletic Trainer in Avon, CT. Individual provider (NPI-1).
NPI number1154101822
StatusActive
Last updated in NPPESOct 2, 2023
Details
- NPI
- 1154101822
- Entity type
- Individual (NPI-1)
- Name
- Madison Sides
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 2, 2023
- Certification date
- Oct 1, 2023
- Last updated
- Oct 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
6 Stockbridge DrAvon, CT 06001-4415
Phone 860-810-3699
Mailing address
6 Stockbridge DrAvon, CT 06001-4415
Phone 860-810-3699
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