Provider Demographics
NPI:1851022545
Name:TIMBROOK, ANDREW (MS, ATC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:TIMBROOK
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:ANDREW
Other - Middle Name:
Other - Last Name:TIMBROOK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:2095 HARRODSBURG RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2095 HARRODSBURG RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-4038
Practice Address - Country:US
Practice Address - Phone:270-570-8845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT7742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer