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General NPI Number Information
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NPI Number | 1841511292
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Entity Type | Individual
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Provider Name | TIM L. NOBLES OTR/L
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Gender | Male
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 06/21/2010
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Provider Practice Location Address
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Address Line | 12200 CRABAPPLE RD
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City | ALPHARETTA
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State | GA
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Zip | 30004-4020
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Country | US
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Telephone | 770-573-1715
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Fax | 770-573-0887
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Provider Business Mailing Address
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Address Line | 506 LAZY RIVER LN
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City | WOODSTOCK
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State | GA
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Zip | 30188-2385
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Country | US
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Telephone | 912-266-3356
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 00041
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License Number State | GA
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