Individual
TIMOTHY MACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6200 OREGON AVE NW, WASHINGTON, DC 20015-1543
(202) 541-0150
Mailing address
79 POTOMAC AVE SE APT 942, WASHINGTON, DC 20003-3749
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA000159
DC
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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