Madison M Medlock

NPI #1053976928 in Wagoner, Oklahoma

Provider Information

NPI Number: 1053976928
Entity Type: Individual
Name: Madison M Medlock
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: May 7, 2019
Last Updated: May 7, 2019

Practice Location

Address: 109 S HARRILL AVE
City: Wagoner
State: Oklahoma
ZIP Code: 74467-5317
Phone: (918) 485-0242

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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