Individual
HEIDI OLSEN TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1551 RENAISSANCE TOWNE DR STE 420, BOUNTIFUL, UT 84010-7677
(801) 295-8999
Mailing address
1551 RENAISSANCE TOWNE DR STE 420, BOUNTIFUL, UT 84010-7677
(801) 295-8999
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
269056-2401
UT
Other
Enumeration date
04/02/2019
Last updated
04/02/2019
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