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Individual

TIMOTHY J TILLMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
185 B ST, ASHLAND, OR 97520-1910
(541) 552-0388
(866) 738-3305
Mailing address
1257 SISKIYOU BLVD, PMB 17, ASHLAND, OR 97520-2241
(541) 552-0388
(866) 738-3305

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3742
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
275285
OR
01
825811000
BLUECROSS BLUESHIELD
OR
Enumeration date
10/16/2006
Last updated
08/19/2008
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