Individual
ANTHONY VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1341 PARADISE RD, EDENTON, NC 27932-8503
(252) 482-2538
Mailing address
944 SUMMERSIDE CT, VIRGINIA BEACH, VA 23456-6373
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11128
NC
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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