Individual
COY DANIEL KIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 W LAKE RD, PLEASANT HILL, TN 38578-3002
(931) 277-3518
Mailing address
1328 PISTOL LN, ONEIDA, TN 37841-6900
(423) 215-8123
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6840
TN
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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