Provider Demographics
NPI:1811990278
Name:DAVIS, TIMOTHY ROBERT (CRT)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:ROBERT
Last Name:DAVIS
Suffix:
Gender:M
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3765 TEDS CV
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-8432
Mailing Address - Country:US
Mailing Address - Phone:404-468-8370
Mailing Address - Fax:678-348-7574
Practice Address - Street 1:3765 TEDS CV
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-8432
Practice Address - Country:US
Practice Address - Phone:404-468-8370
Practice Address - Fax:678-348-7574
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0051472278H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome Health