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Individual
JOSHUA EARL LIDER
Active
Individual
JOSHUA EARL LIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
11420218-1204
UT
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
20A19883
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
04/12/2018
Last updated
07/13/2023
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