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Individual

TIMOTHY ST JOHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3179 W HOUGHTON LAKE DR, HOUGHTON LAKE, MI 48629-9256
(989) 366-8332
Mailing address
4310 LEONARD ST NW, SUITE 103, WALKER, MI 49534-8447
(616) 453-6329
(616) 453-1725

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
TS001531
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3119585
MI
Enumeration date
12/24/2005
Last updated
01/04/2010
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