Individual
MR. TIMOTHY K MASSENGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
505 STEVENS ST, NOKOMIS, IL 62075-1442
(217) 563-7725
Mailing address
1055 LOCUST AVE, NEOGA, IL 62447-1404
(217) 419-2260
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160002132
—
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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