Individual
TIMOTHY A AGEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 N LOCKWOOD RIDGE RD, SARASOTA, FL 34237-3218
(941) 362-9627
Mailing address
1501 N LOCKWOOD RIDGE RD, SARASOTA, FL 34237-3218
(941) 362-9627
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA21615
FL
226300000X
Kinesiotherapist
Primary
MA21615
FL
Other
Enumeration date
05/06/2009
Last updated
05/06/2009
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