Organization
TIDAL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDEN CLIMO PT, DPT (CEO, PHYSICAL THERAPIST)
(513) 739-2422
Entity
Organization
Contact information
Practice address
14 LOUIS LN., SOUTHPORT, ME 04576
(513) 739-2422
Mailing address
PO BOX 395, SOUTHPORT, ME 04576-0395
(513) 739-2422
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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