Individual
MR. CHARLES GUY RIDDLE
Active
Individual
MR. CHARLES GUY RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
RPT-1978
ID
225100000X
Physical Therapist
Primary
PT-1978
ID
Other
Enumeration date
10/03/2006
Last updated
04/12/2018
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