Individual
MS. JANA KAY TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3834 INDEPENDENCE DR, ALEXANDRIA, LA 71303-3533
(318) 487-0960
(318) 487-2002
Mailing address
3834 INDEPENDENCE DR, ALEXANDRIA, LA 71303-3533
(318) 487-0960
(318) 487-2002
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LA2759
LA
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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