Individual
TIMOTHY JOHN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
8353 UNIVERSITY BLVD, MOON TWP, PA 15108-4202
(412) 264-9440
Mailing address
898 OLD THORN RUN RD, CORAOPOLIS, PA 15108-1182
(412) 390-6520
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT0068103
PA
Other
Enumeration date
09/30/2021
Last updated
09/30/2021
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