Individual
LAUREN BLAIR TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2317 MEMORIAL PKWY SW STE 300, HUNTSVILLE, AL 35801-5623
(256) 881-4112
Mailing address
2317 MEMORIAL PKWY SW STE 300, HUNTSVILLE, AL 35801-5623
(256) 881-4112
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.1163
AL
Other
Enumeration date
09/23/2016
Last updated
09/11/2021
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