Provider Demographics
NPI:1851522353
Name:SAVAGE, TIMOTHY ALEXANDER (MAED, ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:ALEXANDER
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:MAED, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 ANDREWS CT
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522-7275
Mailing Address - Country:US
Mailing Address - Phone:252-714-7473
Mailing Address - Fax:
Practice Address - Street 1:701 CRESCENT DR
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-8315
Practice Address - Country:US
Practice Address - Phone:919-528-5532
Practice Address - Fax:919-528-5575
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13722255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer