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1528447372
CHRISTINA MICHELLE TIDWELL
VIDALIA, GA
NPI
1528447372
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Former Name
CHRISTINA MICHELLE DACEY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 7597)
Enumeration Date
2015-05-27
Last Update Date
2024-07-25
Business Address
Mrs. CHRISTINA MICHELLE TIDWELL PA
1 MEADOWS PKWY
VIDALIA, GA 30474-8759
Phone number: 912-535-5555
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Mailing Address
Mrs. CHRISTINA MICHELLE TIDWELL PA
PO BOX 597
METTER, GA 30439-0597
Phone number: 912-685-1244
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