Individual
MRS. CHRISTINA MICHELLE TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 MEADOWS PKWY, VIDALIA, GA 30474-8759
(912) 535-5555
(912) 535-5891
Mailing address
PO BOX 597, METTER, GA 30439-0597
(912) 685-1244
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7597
GA
Other
Enumeration date
05/27/2015
Last updated
07/25/2024
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