Individual
MADELINN TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2380 BUFFALO ROAD, LAWRENCEBURG, TN 38464
(931) 762-9418
Mailing address
2380 BUFFALO ROAD, LAWRENCEBURG, TN 38464
(931) 762-9418
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4198
TN
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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