Individual
EVELYN JEAN TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M ED, LAT, RMT
Contact information
Practice address
319 POND VIEW PASS, BUDA, TX 78610-3613
(210) 573-4165
Mailing address
319 POND VIEW PASS, BUDA, TX 78610-3613
(210) 573-4165
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1486
TX
225700000X
Massage Therapist
MT030247
TX
Other
Enumeration date
03/29/2014
Last updated
03/29/2014
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