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1174261192
DALTON TIDWELL
GREENWOOD, SC
NPI
1174261192
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: SC 88141)
Enumeration Date
2022-05-20
Last Update Date
2023-09-15
Business Address
DALTON TIDWELL MD
1325 SPRING ST
GREENWOOD, SC 29646-3860
Phone number: 864-725-4780
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Mailing Address
DALTON TIDWELL MD
155 ACADEMY AVE
GREENWOOD, SC 29646-3869
Phone number:
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