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General NPI Number Information
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NPI Number | 1043416308
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Entity Type | Individual
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Provider Name | TIMOTHY BRIAN MCREATH RPT
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Gender | Male
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7047 OLD MADISON PIKE NW
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City | HUNTSVILLE
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State | AL
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Zip | 35806-4500
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Country | US
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Telephone | 256-922-9919
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Fax |
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Provider Business Mailing Address
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Address Line | 14952 LANCELOT CIRCLE
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City | HARVEST
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State | AL
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Zip | 35749
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Country | US
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Telephone | 256-783-5600
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH2887
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License Number State | AL
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