Individual
DEBRA LYNNETTE RIDDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1670 W LINGLEVILLE RD, STEPHENVILLE, TX 76401-1830
(254) 968-2158
Mailing address
230 MEADOR LN, STEPHENVILLE, TX 76401-3916
(915) 474-1958
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2043545
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2043545
EXECUTIVE COUNCIL OF PT/OT EXAMINERS
TX
Enumeration date
08/29/2018
Last updated
08/29/2018
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