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1811923477
SARA LEE TIDWELL
SALT LAKE CITY, UT
NPI
1811923477
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
231H00000X Audiologist
(Licence: UT 3162644101)
Enumeration Date
2006-06-24
Last Update Date
2007-07-08
Business Address
-- SARA LEE TIDWELL M.S., CCC-A
VA MEDICAL CTR 500 FOOTHILL BLVD.
SALT LAKE CITY, UT 84148-0001
Phone number: 801-584-1242
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Mailing Address
-- SARA LEE TIDWELL M.S., CCC-A
33 E 200 N
NORTH SALT LAKE, UT 84054-2420
Phone number: 801-299-9416
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