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1891243465
NICHOLAS TIDWELL
LAKE MARY, FL
NPI
1891243465
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: FL Ps55365)
Enumeration Date
2016-09-13
Last Update Date
2016-09-13
Business Address
-- NICHOLAS TIDWELL Pharm.D
1521 OBERLIN TER
LAKE MARY, FL 32746-5937
Phone number: 321-274-7830
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Mailing Address
-- NICHOLAS TIDWELL Pharm.D
1521 OBERLIN TER
LAKE MARY, FL 32746-5937
Phone number: 321-274-7830
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