Individual
LLOYD TIMOTHY MCLANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
937 15TH ST, AUGUSTA, GA 30912-0008
(706) 836-6949
Mailing address
1051 ALDER WAY, APT 407, EVANS, GA 30809-9119
(904) 476-8459
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL0000001
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000090290
NATIONAL BOARD
—
01
—
1326
STATE LICENSES
SC
01
—
AL0000001
STATE LICENSE
FL
01
—
AT001723
STATE LICENSE
GA
Enumeration date
07/03/2006
Last updated
04/16/2013
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