Individual
TIMOTHY JOHN CARLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
833 LOUWEN DR, SAINT LOUIS, MO 63124-1803
(503) 756-7785
Mailing address
833 LOUWEN DR, SAINT LOUIS, MO 63124-1803
(503) 756-7785
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2012002876
MO
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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