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Individual

TRACY BIDWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
284 S. RIDGE RD W, CONNEAUT, OH 44030
(440) 813-5131
Mailing address
284 S RIDGE RD W, CONNEAUT, OH 44030-9709
(440) 813-5131

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
0126454
OH

Other

Enumeration date
01/30/2012
Last updated
01/30/2012
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