JONTA DELISA TIDWELL

FARGO, ND
NPI1912524273
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy251E00000X Home Health
Enumeration Date2020-07-01
Last Update Date2020-07-01
Business Address
JONTA DELISA TIDWELL
3026 18TH ST S
FARGO, ND 58103-6716
Phone number: 480-286-8603
Mailing Address
JONTA DELISA TIDWELL
3026 18TH ST S
FARGO, ND 58103-6716
Phone number: 480-286-8603
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