Individual
CHERYL TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
90 RIVERMIST DR, COVINGTON, GA 30014-1080
(470) 327-8508
(678) 660-3692
Mailing address
90 RIVERMIST DR, COVINGTON, GA 30014-1080
(470) 327-8508
(678) 660-3692
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
049192828
GA
Other
Enumeration date
06/25/2022
Last updated
06/25/2022
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