Individual
MS. STACY MARIE BIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4535
OK
225100000X
Physical Therapist
7501
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179814
—
AZ
Enumeration date
01/17/2007
Last updated
06/03/2015
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