Individual
TIMOTHY JAMES CRILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, EMT
Contact information
Practice address
625 PARK AVE, LAGUNA BEACH, CA 92651-2340
(949) 497-7750
Mailing address
625 PARK AVE, LAGUNA BEACH, CA 92651-2340
(949) 497-7750
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/11/2018
Last updated
01/13/2021
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