Individual
RAYMOND CRUZ TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3701 LOOP RD, TUSCALOOSA, AL 35404-5015
(205) 544-2000
Mailing address
116 MCDONALD RD, JASPER, AL 35501-9300
(205) 544-6694
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
21918
AL
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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