Individual
DR. KAITLYN TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
6242 POPLAR AVE, MEMPHIS, TN 38119-4730
(901) 842-4327
Mailing address
6242 POPLAR AVE, MEMPHIS, TN 38119-4730
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1702
TN
Other
Enumeration date
07/08/2015
Last updated
07/08/2015
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