Individual
TIMOTHY OBRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
330 3RD ST NE, MAYVILLE STATE UIVERSITY, MAYVILLE, ND 58257-1217
(701) 788-4844
(701) 788-4840
Mailing address
330 3RD ST NE, MAYVILLE STATE UIVERSITY, MAYVILLE, ND 58257-1217
(701) 788-4844
(701) 788-4840
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
103-92
ND
Other
Enumeration date
05/07/2014
Last updated
05/07/2014
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