Individual
MS. LACINDA SUE TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
2920 CHERRY ST, TOLEDO, OH 43608-1716
(419) 242-7458
Mailing address
405 DANESMOOR CT, HOLLAND, OH 43528-9510
(419) 865-2607
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001895
OH
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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