Individual
DANIELLE PAIGE KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
801 MUSGROVE ST, CLINTON, SC 29325-1752
(864) 939-8384
Mailing address
1212 METZE RD APT 13B, COLUMBIA, SC 29210-0751
(304) 917-9199
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4185
SC
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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