Individual
MR. RODERICK MICHAEL HYDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-1154
Mailing address
820 3RD ST S, WISCONSIN RAPIDS, WI 54494-4725
(715) 712-0388
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1871-023
WI
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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