Individual
TRAVIS TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2710 SAINT FRANCIS DR STE 510, WATERLOO, IA 50702-5620
(319) 272-5000
(319) 272-5236
Mailing address
754 S MAIN ST, ST GEORGE, UT 84770-5504
(435) 628-2671
(435) 674-1601
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
074484
IA
213E00000X
Podiatrist
Primary
5593046-0501
UT
Other
Enumeration date
07/21/2014
Last updated
05/16/2022
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