Individual
MARCIA W KIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
391 SOUTHCREST CIR, SUITE 205, SOUTHAVEN, MS 38671-6730
(662) 536-0900
(662) 536-0914
Mailing address
391 SOUTHCREST CIR, SUITE 205, SOUTHAVEN, MS 38671-6730
(662) 536-0900
(662) 536-0914
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0274
MS
Other
Enumeration date
02/26/2008
Last updated
02/02/2010
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