Individual
JAMIE TIDSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2255 S LINDEN RD, FLINT, MI 48532-5417
(810) 732-8087
Mailing address
2255 S LINDEN RD, FLINT, MI 48532-5417
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703119705
MI
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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