Organization
ACCIDENT SPINE & REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT ALAN TIDWELL D.C. (PRESIDENT)
(205) 561-6015
Entity
Organization
Contact information
Practice address
1401 3RD AVE W, SUITE 108, BIRMINGHAM, AL 35208-5300
(205) 561-6015
(205) 957-6740
Mailing address
819 MIMOSA PARK RD, TUSCALOOSA, AL 35405-4839
(205) 561-6015
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
2100
AL
Other
Enumeration date
12/16/2013
Last updated
08/20/2015
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