Provider Demographics
NPI:1669973590
Name:HOUTZ, TIMOTHY JORDON (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JORDON
Last Name:HOUTZ
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 1:740 WHIPPLE RD
Mailing Address - Street 2:
Mailing Address - City:BRONSON
Mailing Address - State:MI
Mailing Address - Zip Code:49028-9784
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:320 E CHICAGO ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2068
Practice Address - Country:US
Practice Address - Phone:517-279-5457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017887225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist