Individual
LYNN TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
929 MEADOW CT, WINCHESTER, VA 22601-2879
(703) 675-0701
Mailing address
929 MEADOW CT, WINCHESTER, VA 22601-2879
(703) 675-0701
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305002245
VA
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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