LISA M. TIDMAN

WILLISTON, VT
NPI1467413930
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2081S0010X Physical Medicine & Rehabilitation, Sports Medicine
(Licence: VT  041-0000385)
Enumeration Date2006-03-31
Last Update Date2007-07-08
Business Address
Mrs. LISA M. TIDMAN PTA
30 HAWTHORNE ST
WILLISTON, VT 05495-8212
Phone number: 802-876-6100
Mailing Address
Mrs. LISA M. TIDMAN PTA
14 FOREST RD
ESSEX, VT 05452-3818
Phone number: 802-878-7536