Provider Demographics
NPI:1356041156
Name:GALUSHA, MADISON LOUISE
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:LOUISE
Last Name:GALUSHA
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 1:620 FARM LN # 240F
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-1600
Mailing Address - Country:US
Mailing Address - Phone:517-355-8537
Mailing Address - Fax:
Practice Address - Street 1:4552 SPAHR ST
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-1122
Practice Address - Country:US
Practice Address - Phone:517-355-8537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other