Individual
MIGUEL VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
102 CAMPUS AVE, LEWISTON, ME 04240-6019
(207) 777-8100
Mailing address
4010 15TH ST SW, LEHIGH ACRES, FL 33976-3201
(239) 470-8022
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6986
ME
Other
Enumeration date
11/15/2024
Last updated
11/15/2024
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