Individual
TIMOTHY JOHN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1009 W GREEN ST, HASTINGS, MI 49058-1790
(219) 738-5510
Mailing address
4100 EMBASSY DR SE, GRAND RAPIDS, MI 49546-2416
(616) 975-1845
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
08/20/2024
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