Provider Demographics
NPI:1093709644
Name:SPEICHER, TIMOTHY EUGENE (ATC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:EUGENE
Last Name:SPEICHER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BLUE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-5001
Mailing Address - Country:US
Mailing Address - Phone:860-344-1399
Mailing Address - Fax:203-365-4723
Practice Address - Street 1:15 BLUE HILL RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-5001
Practice Address - Country:US
Practice Address - Phone:860-344-1399
Practice Address - Fax:203-365-4723
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer