MRS. Lisa M. Tidman, PTA

NPI #1467413930 in Williston, Vermont

Provider Information

NPI Number
1467413930
Entity Type
Individual
Name
MRS. Lisa M. Tidman, PTA
Gender
Not Specified
Sole Proprietor
Not Answered
Primary Specialty
Physical Medicine & Rehabilitation - Sports Medicine
Credential
PTA
Enumeration Date
Mar 31, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
30 HAWTHORNE ST
State
Vermont
ZIP Code
05495-8212
Phone
(802) 876-6100

Specialties & Taxonomy Codes

Specialty
Physical Medicine & Rehabilitation - Sports MedicineSports Medicine

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