Individual
THERESA TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
737 U.S. 287 FRONTAGE RD, BUILDING100, MANSFIELD, TX 76063
(817) 908-2805
Mailing address
737 U.S. 287 FRONTAGE RD, BUILDING100, MANSFIELD, TX 76063
(817) 908-2805
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT148628
TX
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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