Individual
TIMOTHY HEATH BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
354 NEWNAN CROSSING BYP, SUITE 200, NEWNAN, GA 30265-2323
(770) 460-4747
(678) 673-5102
Mailing address
900 CIRCLE 75 PKWY SE, SUITE 1700, ATLANTA, GA 30339-3035
(770) 953-6929
(770) 953-6972
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002165
GA
Other
Enumeration date
09/11/2012
Last updated
10/30/2015
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