Individual
EILEEN STIDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
1111 W TOWN AND COUNTRY RD STE 1, ORANGE, CA 92868-4635
(714) 997-5518
Mailing address
47 GOLDBRIAR WAY, MISSION VIEJO, CA 92692-5986
(949) 285-3195
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT-5906
CA
Other
Enumeration date
03/14/2014
Last updated
03/14/2014
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