Individual
MR. ALLAN P. TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
215 E WATER ST, MUNCY, PA 17756-8828
(570) 321-2850
(570) 321-2851
Mailing address
701 MANATEE AVE W, STE 101, BRADENTON, FL 34205-8624
(941) 748-3065
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107652
FL
Other
Enumeration date
05/19/2006
Last updated
07/21/2022
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