Most Relevant Information
Provider Data
| NPI Number: | 1003458456 |
| Provider Name: | MADISON GUARD |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/16/2019 |
| Last Updated: | 10/16/2019 |
Provider Practice Location
5215 N SABINO CANYON RD
TUCSON
AZ
857506435
Practice Location Phone/Fax
| Phone: | 8667278274 |
| Fax: |
Provider Mailing Location
5215 N SABINO CANYON RD
TUCSON
AZ
857506435
Provider Mailing Phone/Fax
| Phone: | 8667278274 |
| Fax: |