Provider Demographics
NPI:1477769511
Name:GOLDING, TIMOTHY W (ACUPUNCTURE PHYSICIA)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:W
Last Name:GOLDING
Suffix:
Gender:M
Credentials:ACUPUNCTURE PHYSICIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:961 LISKEARD AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-5733
Mailing Address - Country:US
Mailing Address - Phone:386-801-6970
Mailing Address - Fax:386-775-6915
Practice Address - Street 1:961 LISKEARD AVE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-5733
Practice Address - Country:US
Practice Address - Phone:386-801-6970
Practice Address - Fax:386-775-6915
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1708171100000X
NY001832-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist