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Individual

MR. TIMOTHY MICHAEL BLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, PTA

Contact information

Practice address
3385 DEXTER CT, SUITE 301, DAVENPORT, IA 52807-3471
(563) 344-6645
(563) 441-7796
Mailing address
5 PARK LANE CT, ELDRIDGE, IA 52748-9676
(563) 249-0162
(563) 441-7796

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
004964
IA
2255A2300X
Athletic Trainer
Primary
00283
IA

Other

Enumeration date
05/20/2007
Last updated
12/01/2012
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