Provider Demographics
NPI:1083009104
Name:FELDMANN, TIMOTHY (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:FELDMANN
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 UNIVERSITY DR
Mailing Address - Street 2:APT 4
Mailing Address - City:MURFREESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27855-1853
Mailing Address - Country:US
Mailing Address - Phone:919-605-1677
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY PL
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:NC
Practice Address - Zip Code:27855-1855
Practice Address - Country:US
Practice Address - Phone:252-398-6291
Practice Address - Fax:252-398-6532
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-25302255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer