Tidball, Abigail

Tidball, Abigail is an individual health care provider with primary practice located at 814 Shanahan Rd Ste 100 , Lewis Center OH 43035-9192. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Tidball, Abigail can be contacted via phone (937) 206-2090.

Contact Information

Primary practice address
814 Shanahan Rd Ste 100 Lewis Center OH 43035-9192
Phone: (937) 206-2090
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 11357 Ohio

Profile Details

NPI number 1013373596
LBN Legal business name Tidball, Abigail
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2016
Last updated Jun 12th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013373596 NPPES
Ohio MEDICAID 0220627

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