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General NPI Number Information
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NPI Number | 1720705924
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Entity Type | Individual
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Provider Name | TIMOTHY THOMAS GUILLIAMS
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Gender | Male
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 85 PINE ST APT 211
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City | COSHOCTON
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State | OH
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Zip | 43812-1937
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Country | US
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Telephone | 740-295-9684
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Fax |
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Provider Business Mailing Address
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Address Line | 1245 VINE ST
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City | COSHOCTON
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State | OH
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Zip | 43812-2450
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Country | US
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Telephone | 740-575-3134
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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