Individual
SIDEA MCCORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRANIAL PROTHESIS
Contact information
Practice address
11806 WHITE ASH DR, NEW PORT RICHEY, FL 34654-1938
(678) 815-3738
Mailing address
11806 WHITE ASH DR, NEW PORT RICHEY, FL 34654-1938
(678) 815-3738
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CO129097
GA
Other
Enumeration date
02/09/2024
Last updated
02/09/2024
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