Individual
TIMOTHY FORMANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3701 KATZ DR, MARION, IA 52302-3871
(319) 373-3022
Mailing address
3701 KATZ DR, MARION, IA 52302-3871
(319) 373-3022
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
131043
IA
Other
Enumeration date
05/17/2006
Last updated
06/10/2025
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