Provider Demographics
NPI:1235789488
Name:FRANKS, THEODORE TIMOTHY
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:TIMOTHY
Last Name:FRANKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 32ND ST NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-6008
Mailing Address - Country:US
Mailing Address - Phone:319-229-8878
Mailing Address - Fax:
Practice Address - Street 1:136 32ND ST NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-6008
Practice Address - Country:US
Practice Address - Phone:319-229-8878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care