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General NPI Number Information
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NPI Number | 1114693447
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Entity Type | Individual
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Provider Name | TIMOTHY HIGGINS
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Gender | Male
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 331 VERANDA ST STE 401
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City | PORTLAND
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State | ME
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Zip | 04103-5545
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Country | US
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Telephone | 207-536-0702
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Fax | 207-536-0785
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Provider Business Mailing Address
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Address Line | 1622 DAKOTA ST UNIT 101
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City | SAN ANTONIO
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State | TX
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Zip | 78203-1727
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Country | US
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Telephone |
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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 | 1324661
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT6763
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License Number State | ME
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