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NPI Profile for BRENDA DEIDRICK in ROSEVILLE, CA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Hand |
2251H1200X | 65 | Physical Therapist in Private Practice |
| NPI # | 1871667022 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 11/20/2006 | |
| Last updated | 07/08/2007 - About 19 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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BRENDA DEIDRICK
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BRENDA DEIDRICK