Provider Demographics
NPI:1639617863
Name:SUMMERS, TIMOTHY (HAP)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:HAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 BLAKE AVE
Mailing Address - Street 2:SUITE #203
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4275
Mailing Address - Country:US
Mailing Address - Phone:970-945-8989
Mailing Address - Fax:
Practice Address - Street 1:1830 BLAKE AVE
Practice Address - Street 2:SUITE #203
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4275
Practice Address - Country:US
Practice Address - Phone:970-945-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHAD.0000321237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist