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Individual
MR. TIMOTHY D MIESMER
Active
Individual
MR. TIMOTHY D MIESMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
AT1210
KY
2255A2300X
Athletic Trainer
Primary
AL5565
FL
Other
Enumeration date
02/20/2008
Last updated
03/18/2020
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