Provider Demographics
NPI:1982074175
Name:MCNAIR, TIMOTHY CLAIR (ATC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:CLAIR
Last Name:MCNAIR
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 DEERFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-9763
Mailing Address - Country:US
Mailing Address - Phone:269-470-5545
Mailing Address - Fax:
Practice Address - Street 1:1446 DEERFIELD ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9763
Practice Address - Country:US
Practice Address - Phone:269-470-5545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer