Individual
MR. TIMOTHY DALTON ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
718 MAGNOLIA DR, TUSCALOOSA, AL 35487-0001
(256) 478-0212
Mailing address
538 HARGROVE RD, TUSCALOOSA, AL 35401-4930
(256) 478-0212
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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