Organization
TIMOTHY STREET
Active
Other names
T L C Medical Transportation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY JOHN STREET (TRANSPORTATION VENDOR)
(423) 895-0425
Entity
Organization
Contact information
Practice address
204 OLD SIAM RD, ELIZABETHTON, TN 37643
(423) 895-0425
(423) 543-7707
Mailing address
204 OLD SIAM RD, ELIZABETHTON, TN 37643
(423) 895-0425
(423) 543-7707
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
052488290
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T000186
—
TN
Enumeration date
04/26/2007
Last updated
08/06/2008
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