TIDWELL FAMILY VENTURES LLC

PORTLAND, TN
NPI1518106020
Doing Business AsPORTLAND FAMILY CARE AND WALK-IN CLINIC
Entity TypeOrganization
Authorized ContactEMILY TIDWELL
Member
615-323-1020
Organization Subpart ?No
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: TN  10971)
Additional Taxonomies207Q00000X Family Medicine
(Licence: TN  1755)
363LF0000X Nurse Practitioner, Family
(Licence: TN  13982)
Enumeration Date2009-02-08
Last Update Date2009-08-05
Business Address
TIDWELL FAMILY VENTURES LLC
505 S BROADWAY
PORTLAND, TN 37148-1438
Phone number: 615-323-1020
Mailing Address
TIDWELL FAMILY VENTURES LLC
505 S BROADWAY
PORTLAND, TN 37148-1438
Phone number: 615-323-1020