# COMPLETE HEALTH & WELLNESS OF AL, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649569963
- **Authorized official:** BRENT ALAN TIDWELL (PRES)
- **Authorized official phone:** (205) 343-7743

## Contact information

- **Practice address:** 819 MIMOSA PARK RD, SUITE C, TUSCALOOSA, AL 35405-4839
- **Practice address phone:** (205) 343-7743
- **Practice address fax:** (205) 752-7513
- **Mailing address:** 819 MIMOSA PARK ROAD, SUITE C, TUSCALOOSA, AL 35405
- **Mailing address phone:** (205) 343-7743
- **Mailing address fax:** (205) 752-7513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 27746 | AL | Yes |
| 363LF0000X | Family Nurse Practitioner | 1-079816 | AL | — |

## Other

- **Enumeration date:** 04/07/2011
- **Last updated:** 04/11/2011