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NPI Code Detail

MEDICARE: TIMOTHY MIDDICK

MEDICARE: TIMOTHY MIDDICK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOTA849CA

General Provider Information

NPI Number : 1881136380
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY MIDDICK
Provider Business Mailing Address
First Line : 2990 E RAMON RD
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92264-7931
Country : US
Telephone Number : 760-323-2638
Fax Number :
Provider Business Practice Location Address
First Line : 2990 E RAMON RD
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92264-7931
Country : US
Telephone Number : 760-323-2638
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2016
Last Update Date : 11/15/2016

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Directions to “ TIMOTHY MIDDICK ” Practice Location

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