Individual
MRS. BOBBI JO RIDENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
002766
WV
225100000X
Physical Therapist
Primary
2766
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810015796
—
WV
Enumeration date
07/08/2009
Last updated
07/12/2012
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