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Individual

TABITHA LYNN STIDHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2531 CRAFT COLLY RD, ERMINE, KY 41815-9025
(606) 632-0108
Mailing address
2531 CRAFT COLLY RD, ERMINE, KY 41815-9025

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AO1915
KY

Other

Enumeration date
01/26/2012
Last updated
01/26/2012
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