Individual
TIMOTHY OLIVER HERLIHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3026 LACLEDE AVE, SAINT LOUIS, MO 63103-2136
(314) 340-5988
Mailing address
11611 MISTY MOSS CT, SAINT LOUIS, MO 63146-4250
(314) 552-1224
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2011030846
MO
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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