Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. LISA M. TIDMAN, PTA
ActiveMRS. LISA M. TIDMAN, PTA is a Sports Medicine (PM&R) healthcare provider located in WILLISTON, Vermont. NPI 1467413930 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (PM&R) · WILLISTON, VT
Registration Details
- NPI Number
- 1467413930
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 31, 2006 (20.33666506342 yrs)
- Last Updated
- Jul 8, 2007
- License
-
041-0000385 (VT)
Practice Information
- Address
-
30 HAWTHORNE STWILLISTON, VT, 054958212Browse VT providers · Browse ZIP 05495
- Phone
- 8028766100
- Primary Specialty
-
Sports Medicine (PM&R)
2081S0010X
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.