Individual
TIMOTHY GLENN EIKOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 445-4860
Mailing address
5448 MIDWINTER MIST ST, NORTH LAS VEGAS, NV 89031-7937
(760) 953-0739
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
Primary
—
—
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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