Tiedeman, Mark Andrew

Tiedeman, Mark Andrew is an sole proprietor health care provider with primary practice located at 5927 Kanan Rd , Agoura Hills CA 91301-1688. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Tiedeman, Mark Andrew can be contacted via phone (818) 889-0158.

Contact Information

Primary practice address
5927 Kanan Rd Agoura Hills CA 91301-1688
Phone: (818) 889-0158
Fax: (818) 889-4708
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT27038 California

Profile Details

NPI number 1730478066
LBN Legal business name Tiedeman, Mark Andrew
Credentials PHYSICAL THERAPIST
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 7th, 2011
Last updated Apr 7th, 2011 - about 15 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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