Individual
KEVIN RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
345 SMITH AVE N, SAINT PAUL, MN 55102-2346
(651) 220-6283
Mailing address
345 SMITH AVE N, SAINT PAUL, MN 55102-2346
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
6081
MN
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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