Individual
MICHAEL DWAIN TIMPSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4625 BRIARBERRY DR, VALDOSTA, GA 31602-6768
(407) 694-9189
Mailing address
4625 BRIARBERRY DR, VALDOSTA, GA 31602-6768
(407) 694-9189
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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