Individual
BRIAN PAUL RIDENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
5225 S LOOP 289 STE 210, LUBBOCK, TX 79424-1319
(806) 780-4180
Mailing address
305 NE LOOP 820; BUSINESS TOWER 1, SUITE 200, HURST, TX 76503
(817) 292-8787
(817) 789-6849
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
113474
TX
Other
Enumeration date
03/04/2010
Last updated
06/11/2014
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