Individual
MICHAEL KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
781 BLACK OAK DR STE 102, MEDFORD, OR 97504-9501
(541) 789-4236
Mailing address
781 BLACK OAK DR STE 102, MEDFORD, OR 97504-9501
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
358055
OR
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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