Individual
SHAWNA KIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 BELLOAK DR, KETTERING, OH 45440-2007
(937) 271-9965
Mailing address
2301 BELLOAK DR, KETTERING, OH 45440-2007
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA010410
OH
Other
Enumeration date
12/14/2022
Last updated
12/14/2022
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