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Individual

MR. TIMOTHY ALLEN TOMMERUP

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MS, ATC

Contact information

Practice address
300 N BROADWAY, LEXINGTON, KY 40508-1797
(859) 233-8850
(859) 233-8638
Mailing address
491 STRATFORD DR, LEXINGTON, KY 40503-1814
(859) 373-0489

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT624
KY

Other

Enumeration date
05/04/2006
Last updated
07/08/2007
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