Individual
TONY MAURICE TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4503 DEVONHILL LN, CHARLOTTE, NC 28269-4077
(980) 215-3027
Mailing address
4503 DEVONHILL LN, CHARLOTTE, NC 28269-4077
(980) 215-3027
Taxonomy
Speciality
Code
Description
License number
State
342000000X
Transportation Network Company
Primary
27832707
NC
Other
Enumeration date
06/05/2022
Last updated
06/05/2022
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