Individual
TIMOTHY ERTSGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
807 DONNELL BLVD STE R, DALEVILLE, AL 36322-2111
(334) 709-4386
Mailing address
807 DONNELL BLVD STE R, DALEVILLE, AL 36322-2111
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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