Provider Demographics
NPI:1255909792
Name:RUNNION, MADISON IRENE
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:IRENE
Last Name:RUNNION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8160 N HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67147-8377
Mailing Address - Country:US
Mailing Address - Phone:316-322-5496
Mailing Address - Fax:
Practice Address - Street 1:1 AEROSPACE BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-3910
Practice Address - Country:US
Practice Address - Phone:316-322-5496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer