Madison Polen, PT

NPI 1912676677 · on the registry since 2021

Practice

Address: 2807 Lake Michigan Dr Nw Ste 1
Grand Rapids, MI 49504
Phone: (616) 828-1326
Fax: (616) 228-9578
Organisation at this address: Athletico Ltd
Affinity Dental Care Plc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 225100000X
225100000X
Licence states on file: MI
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2021-09-07

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan