Individual
MRS. HEATHER NICHOL TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
3658 BELL RD, NASHVILLE, TN 37214-2600
(615) 391-0525
Mailing address
272 DAVIS RD, LEBANON, TN 37087-0900
(615) 417-3817
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3352
TN
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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