Individual
MR. CHAD LEON TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1665 M ST, FRESNO, CA 93721-1121
(559) 268-5361
Mailing address
1300 OWENS RD, AUBURN, AL 36830-2521
(334) 332-5225
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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