| Kort Kids -madison | |
|
2420 Wilson Ave Madison IN 47250-2135 | |
| (812) 265-8226 | |
| Not Available |
| Full Name | Kort Kids -madison |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2420 Wilson Ave, Madison, Indiana |
| Authorized Official Name and Position | Michael Tarvin (VICE PRESIDENT) |
| Authorized Official Contact | 7179721100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kort Kids -madison 4714 Gettysburg Rd Mechanicsburg PA 17055-4325 Ph: () - | Kort Kids -madison 2420 Wilson Ave Madison IN 47250-2135 Ph: (812) 265-8226 |
| NPI Number | 1598487175 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 10/28/2022 |
| Certification Date | 10/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598487175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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