Individual
STEPHANIE LIDDLE
Active
Individual
STEPHANIE LIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-954
ID
2255A2300X
Athletic Trainer
AT-077
ID
Other
Enumeration date
10/29/2007
Last updated
03/14/2023
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