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1639715121
LILLIE TIDWELL
WINTER HAVEN, FL
NPI
1639715121
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
376J00000X Homemaker
(Licence: FL 104129000)
Enumeration Date
2019-11-20
Last Update Date
2022-11-03
Business Address
LILLIE TIDWELL
2332 ISLE ROYALE CT SE
WINTER HAVEN, FL 33880-4325
Phone number: 863-595-6212
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Mailing Address
LILLIE TIDWELL
2332 ISLE ROYALE CT SE
WINTER HAVEN, FL 33880-4325
Phone number: 863-595-6212
Copy
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