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Individual

KATHLEEN MARY SIUDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2171 SENECA RIDGE DR, MYRTLE BEACH, SC 29579-4178
(843) 903-2950
Mailing address
2171 SENECA RIDGE DR, MYRTLE BEACH, SC 29579-4178
(843) 903-2950

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2586
SC

Other

Enumeration date
09/14/2011
Last updated
09/14/2011
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