| NPI | 1417097718 |
|---|---|
| Doing Business As | TIDEWATER CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | CORNELIUS TUCKER CARWILE President Clinic Director 757-465-7299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104001982) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2008-02-19 |