Individual
MRS. JILL S VIDRINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
536 S TRIMBLE RD, MANSFIELD, OH 44906-3418
(419) 756-8899
Mailing address
536 S TRIMBLE RD, MANSFIELD, OH 44906-3418
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003323
OH
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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