Individual
MARYANN TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
930 W WARNER RD, SUITE 32, CHANDLER, AZ 85225-1040
(602) 743-4263
Mailing address
2104 N LOS ALTOS DR, CHANDLER, AZ 85224-2135
(602) 743-4263
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10661
AZ
Other
Enumeration date
11/07/2010
Last updated
12/02/2010
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