| NPI | 1730510116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT ALAN TIDWELL President 334-440-6757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: AL 2162) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2013-12-10 |