Individual
DOUGLAS KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4386 MOHAVE DRIVE, WESTMINSTER DR, MD 21157
(877) 430-2772
Mailing address
4386 MOHAVE DRIVE, WESTMINSTER DR, MD 21157
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A1963
MD
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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