Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MADISON JO LAKE
ActiveMADISON JO LAKE is a Athletic Trainer healthcare provider located in SEBEKA, Minnesota. NPI 1407446842 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · SEBEKA, MN
Registration Details
- NPI Number
- 1407446842
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 20, 2021 (5.5575612707483 yrs)
- Last Updated
- Jan 20, 2021
Practice Information
- Address
-
1001 WELLS AVE ESEBEKA, MN, 564772730Browse MN providers · Browse ZIP 56477
- Phone
- 2186393676
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.