Individual
MICHELLE NIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
144 S CAROL MALONE BLVD, GRAYSON, KY 41143-1352
(606) 474-7901
Mailing address
58 PRIVATE DRIVE 699, WILLOW WOOD, OH 45696-8949
(740) 867-0817
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A01657
KY
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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