Healthcare Provider Details

I. General information

NPI: 1124938873
Provider Name (Legal Business Name): TIMOTHY STURTZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BUTTONWOOD WAY
LITTLETON MA
01460-2244
US

IV. Provider business mailing address

3 BUTTONWOOD WAY
LITTLETON MA
01460-2244
US

V. Phone/Fax

Practice location:
  • Phone: 978-846-7862
  • Fax:
Mailing address:
  • Phone: 978-846-7862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: