Individual
BRENNA K TIMMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
25600 NYS ROUTE 342, STE. C & D, EVANS MILLS, NY 13637-3256
(315) 221-5101
Mailing address
111 WENDELL LN, BLACK RIVER, NY 13612-2111
(610) 724-0834
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
039554-1
NY
225100000X
Physical Therapist
10169
TN
Other
Enumeration date
08/14/2014
Last updated
02/19/2016
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