Organization
TIDEWATER HOME MODIFIERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHESTLEY THOMAS COWLING JR. (OWNER/MEMBER)
(757) 618-4064
Entity
Organization
Contact information
Practice address
206 MARINA CT, CHESAPEAKE, VA 23320-3402
(757) 618-4064
Mailing address
206 MARINA CT, CHESAPEAKE, VA 23320-3402
(757) 618-4064
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
12/28/2013
Last updated
12/28/2013
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