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1497204002
LAUREN BLAIR TIDWELL
HUNTSVILLE, AL
NPI
1497204002
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: AL PA.1163)
Enumeration Date
2016-09-23
Last Update Date
2021-09-11
Business Address
LAUREN BLAIR TIDWELL PA-C
2317 MEMORIAL PKWY SW STE 300
HUNTSVILLE, AL 35801-5623
Phone number: 256-881-4112
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Mailing Address
LAUREN BLAIR TIDWELL PA-C
2317 MEMORIAL PKWY SW STE 300
HUNTSVILLE, AL 35801-5623
Phone number: 256-881-4112
Copy
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