Individual
MICAH KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 S 5TH AVE, WEST READING, PA 19611-2143
(484) 628-7115
Mailing address
218 E MAIN ST, KUTZTOWN, PA 19530-1517
(484) 258-4372
Taxonomy
Speciality
Code
Description
License number
State
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
RN664312
PA
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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