Individual
DR. HEATHER ANGELICA TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
2930 N 67TH AVE, PHOENIX, AZ 85033-5610
(623) 849-6991
Mailing address
4502 E SAN GABRIEL AVE, PHOENIX, AZ 85044-1429
(404) 542-1626
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S019535
AZ
Other
Enumeration date
12/17/2012
Last updated
12/17/2012
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