Individual
ASHLEY K TIDBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HBKIN, PT, DPT
Contact information
Practice address
400 INTERNATIONAL PKWY, SUITE 300, LAKE MARY, FL 32746-5061
(407) 732-5828
(866) 214-4756
Mailing address
2507 HAMILTON RD, BRIGHTS GROVE, ONTARIO N0N 1-C0
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1201708
TX
Other
Enumeration date
11/15/2010
Last updated
11/15/2010
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