MRS. Jill S Vidrine, PA-C

NPI #1114200565 in Mansfield, Ohio

Provider Information

NPI Number: 1114200565
Entity Type: Individual
Name: MRS. Jill S Vidrine, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Sep 22, 2011
Last Updated: Sep 22, 2011

Practice Location

Address: 536 S TRIMBLE RD
City: Mansfield
State: Ohio
ZIP Code: 44906-3418
Phone: (419) 756-8899

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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