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1306129770
HEATH WILLIAM HALL TIDWELL
FORT WORTH, TX
NPI
1306129770
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: TX 208454)
Enumeration Date
2011-09-22
Last Update Date
2011-09-22
Business Address
-- HEATH WILLIAM HALL TIDWELL
5316 TRAIL LAKE DR
FORT WORTH, TX 76133-1931
Phone number: 817-292-8787
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Mailing Address
-- HEATH WILLIAM HALL TIDWELL
5316 TRAIL LAKE DR
FORT WORTH, TX 76133-1931
Phone number: 817-292-8787
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