Healthcare Provider Details

I. General information

NPI: 1982702163
Provider Name (Legal Business Name): AMERICAN ALTERNATIVE HEALTHCARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6521 HIGHWAY 69 S SUITE N
TUSCALOOSA AL
35405-3964
US

IV. Provider business mailing address

6521 HIGHWAY 69 S SUITE N
TUSCALOOSA AL
35405-3964
US

V. Phone/Fax

Practice location:
  • Phone: 205-752-7503
  • Fax: 205-752-7513
Mailing address:
  • Phone: 205-752-7503
  • Fax: 205-752-7513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. BRENT ALAN TIDWELL
Title or Position: CHIROPRACTOR / OWNER
Credential: D.C.
Phone: 205-752-7503