Individual
AMY TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1751 TINY TOWN RD, CLARKSVILLE, TN 37042-7632
(931) 552-7464
Mailing address
1751 TINY TOWN RD, CLARKSVILLE, TN 37042-7632
(931) 552-7464
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
42133
TN
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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