Individual
ANDREA COLETTE RIDOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6000 HOSPITAL DRIVE, HANNIBAL, MO 63401
(573) 406-0576
Mailing address
7531 COUNTY ROAD 426, HANNIBAL, MO 63401-6634
(573) 248-2979
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
115419
MO
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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