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1184239972
LUKE EIDSON TIDWELL
NEWNAN, GA
NPI
1184239972
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: GA PT014897)
Enumeration Date
2020-09-09
Last Update Date
2020-09-09
Business Address
LUKE EIDSON TIDWELL PT
1755 HIGHWAY 34 E STE 1300
NEWNAN, GA 30265-3186
Phone number: 770-254-7850
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Mailing Address
LUKE EIDSON TIDWELL PT
1755 HIGHWAY 34 E STE 1300
NEWNAN, GA 30265-3186
Phone number: 770-254-7850
Copy
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