Individual
TIMOTHY COREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C, M.ED, CSCS
Contact information
Practice address
15 ENTERPRISE DR, AUGUSTA, ME 04330-7997
(774) 279-4794
Mailing address
126 LIBBY LN, WEST GARDINER, ME 04345-3274
(774) 279-4794
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2708
ME
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/04/2023
Last updated
09/02/2024
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