Individual
TIMOTHY WILLIAM PIECZARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC, EMT
Contact information
Practice address
11011 W NORTH AVE APT 119, WAUWATOSA, WI 53226-2275
(724) 809-7968
Mailing address
11011 W NORTH AVE APT 119, WAUWATOSA, WI 53226-2275
(724) 809-7968
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
0966488
PA
2255A2300X
Athletic Trainer
Primary
3124-39
WI
2255A2300X
Athletic Trainer
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Other
Enumeration date
11/25/2019
Last updated
09/26/2023
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