Individual
TIMOTHY M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2637 PINE TREE DR, MIRAMAR, FL 33023
(845) 694-7353
Mailing address
2637 PINE TREE DR, MIRAMAR, FL 33023-4508
(845) 694-7353
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
172A00000X
Driver
—
—
Other
Enumeration date
12/02/2016
Last updated
07/27/2018
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