Individual
MAE DIPLOMA TIDALGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1284660
TX
225100000X
Physical Therapist
CP050840T
TN
225100000X
Physical Therapist
Primary
PTH8746
AL
Other
Enumeration date
02/01/2019
Last updated
11/11/2025
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