Individual
KATHLEEN SIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 SAINT LOUIS AVE STE 102, FORT WORTH, TX 76104-3377
(817) 921-5020
(817) 921-5022
Mailing address
1000 SAINT LOUIS AVE STE 102, FORT WORTH, TX 76104-3377
(817) 921-5020
(817) 921-5022
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2114731
TX
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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