Individual
KURT RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14708 AGNES AVE, EASTPOINTE, MI 48021-2879
(586) 943-6138
Mailing address
14708 AGNES AVE, EASTPOINTE, MI 48021-2879
(586) 943-6138
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502004284
MI
Other
Enumeration date
05/29/2017
Last updated
07/21/2022
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