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Individual

CARRIE M TEDRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT, ATC

Contact information

Practice address
215 S GRANT ST, CLINTON, IL 61727-1926
(904) 347-6808
Mailing address
215 S GRANT ST, CLINTON, IL 61727-1926
(904) 347-6808

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 29267
CA
225100000X
Physical Therapist
Primary
IL
2255A2300X
Athletic Trainer

Other

Enumeration date
08/09/2007
Last updated
08/10/2007
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