Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
VICTOR ERUDE LIDAYWA, DPT
Active Sole ProprietorVICTOR ERUDE LIDAYWA, DPT is a Physical Therapy Clinic healthcare provider located in MACOMB, Illinois. NPI 1083178198 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Clinic · MACOMB, IL
Registration Details
- NPI Number
- 1083178198
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 23, 2019 (7.5596329770287 yrs)
- Last Updated
- Feb 2, 2019
- Licenses
-
070.017800 (IL)070.017800 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1701 W JACKSON STSTE CMACOMB, IL, 614553175Browse IL providers · Browse ZIP 61455
- Phone
- 3093313590
- Primary Specialty
-
Physical Therapy Clinic
261QP2000X
- Additional Specialty
- Physical Therapy Clinic
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.