HEATH WILLIAM HALL TIDWELL

FORT WORTH, TX
NPI1306129770
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: TX  208454)
Enumeration Date2011-09-22
Last Update Date2011-09-22
Business Address
-- HEATH WILLIAM HALL TIDWELL
5316 TRAIL LAKE DR
FORT WORTH, TX 76133-1931
Phone number: 817-292-8787
Mailing Address
-- HEATH WILLIAM HALL TIDWELL
5316 TRAIL LAKE DR
FORT WORTH, TX 76133-1931
Phone number: 817-292-8787