Individual
TIMOTHY LEE BOTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
4400 GOLF ACRES DR, BUILDING J, SUITE D, CHARLOTTE, NC 28208-5990
(704) 796-9961
Mailing address
PO BOX 32861, CHARLOTTE, NC 28232-2861
(704) 588-3762
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0904
NC
Other
Enumeration date
01/19/2012
Last updated
01/25/2012
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