Individual
JODIE K TIMBERLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2325 5TH ST BLDG 675, WRIGHT PATTERSON AFB, OH 45433-7505
(937) 257-0837
Mailing address
2510 5TH ST BLDG 840, WRIGHT PATTERSON AFB, OH 45433-7951
(937) 938-3630
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
0101257066
VA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/26/2013
Last updated
02/28/2022
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