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Individual

ANTONIA TIDWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDMS, RVT, RDCS, RTR

Contact information

Practice address
323 SAVANNAH RDG, MURFREESBORO, TN 37127-8331
(615) 708-3179
Mailing address
323 SAVANNAH RDG, MURFREESBORO, TN 37127-8331

Taxonomy

Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
115198
TN
2471C3402X
Radiography Radiologic Technologist
310458
TN
2471S1302X
Sonography Radiologic Technologist
Primary
115198
TN
2471V0105X
Vascular Sonography Radiologic Technologist
115198
TN

Other

Enumeration date
09/03/2012
Last updated
09/03/2012
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