Organization
COMPLETE HEALTH & WELLNESS OF AL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT ALAN TIDWELL (PRES)
(205) 343-7743
Entity
Organization
Contact information
Practice address
819 MIMOSA PARK RD, SUITE C, TUSCALOOSA, AL 35405-4839
(205) 343-7743
(205) 752-7513
Mailing address
819 MIMOSA PARK ROAD, SUITE C, TUSCALOOSA, AL 35405
(205) 343-7743
(205) 752-7513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27746
AL
363LF0000X
Family Nurse Practitioner
1-079816
AL
Other
Enumeration date
04/07/2011
Last updated
04/11/2011
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