Individual
MRS. LORENA ELIZABETH TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
WEST END WASHINTON, LAREDO COMMUNITY COLLEGE - ATHLETIC DEPARTMENT, LAREDO, TX 78040
(956) 721-5326
(956) 721-5877
Mailing address
P140 FORT MCINTOSH, LAREDO, TX 78040-4344
(956) 723-1153
(956) 721-5877
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2882
TX
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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