Provider Demographics
NPI:1760743520
Name:TIMMERMAN, TRAVIS PATRICK (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:PATRICK
Last Name:TIMMERMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 SADDLE DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4920
Mailing Address - Country:US
Mailing Address - Phone:406-457-0480
Mailing Address - Fax:406-457-0481
Practice Address - Street 1:251 SADDLE DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4920
Practice Address - Country:US
Practice Address - Phone:406-457-0480
Practice Address - Fax:406-457-0481
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-LIC-5217225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist