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General NPI Number Information
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NPI Number | 1023942463
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Entity Type | Individual
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Provider Name | TIMOTHY ALLAN COLLARD
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Gender | Male
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 903 VALLEY VIEW DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49685-8744
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Country | US
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Telephone | 231-499-0269
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Fax | 231-499-0269
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Provider Business Mailing Address
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Address Line | 903 VALLEY VIEW DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49685-8744
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Country | US
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Telephone | 231-499-0269
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Fax | 231-499-0269
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number | 5802000150
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License Number State | MI
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