Lillie Tidwell
NPI #1639715121 in Winter Haven, Florida
Provider Information
- NPI Number
- 1639715121
- Entity Type
- Individual
- Name
- Lillie Tidwell
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Homemaker
- Enumeration Date
- Nov 20, 2019
- Last Updated
- Nov 3, 2022
Practice Location
- Address
- 2332 ISLE ROYALE CT SE
- City
- Winter Haven
- State
- Florida
- ZIP Code
- 33880-4325
- Phone
- (863) 595-6212
Specialties & Taxonomy Codes
| Specialty |
|---|
| Homemaker |
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