Individual
MR. TIMOTHY JON WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
33 HIGHFIELD DR, FALMOUTH, MA 02540-2303
(508) 548-7491
(508) 457-4907
Mailing address
111 THANKFUL LN, COTUIT, MA 02635-2616
(508) 420-0557
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
557
MA
Other
Enumeration date
01/27/2007
Last updated
07/08/2007
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