Individual
TIMOTHY WILBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
721 HIGHWAY 321 N, LENOIR CITY, TN 37771-5003
(865) 988-0000
(865) 986-1542
Mailing address
171 CORY DRIVE, APT 324, LENOIR CITY, TN 37771-8577
(423) 519-0117
(865) 986-1542
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
41357
TN
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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