Organization
ACCIDENT SPINE & REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT ALAN TIDWELL D.C. (PRESIDENT)
(334) 440-6757
Entity
Organization
Contact information
Practice address
4142 CARMICHAEL RD STE A, MONTGOMERY, AL 36106-2935
(334) 440-6757
Mailing address
819 MIMOSA PARK RD, TUSCALOOSA, AL 35405-4839
(334) 440-6757
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
2162
AL
Other
Enumeration date
12/10/2013
Last updated
12/10/2013
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