Provider Demographics
NPI:1689802522
Name:ECKARD, TIMOTHY GEORGE (DPT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:GEORGE
Last Name:ECKARD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BUILDING 9040 FITZSIMMONS DR.
Mailing Address - Street 2:PHYSICAL THERAPY DEPARTMENT
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431
Mailing Address - Country:US
Mailing Address - Phone:253-968-0780
Mailing Address - Fax:
Practice Address - Street 1:FITZSIMMONS DR BLDG 9040
Practice Address - Street 2:PHYSICAL THERAPY DEPARTMENT
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist