Timothy Street

NPI #1760602338 in Elizabethton, Tennessee

Provider Information

NPI Number: 1760602338
Entity Type: Organization
Organization Name: Timothy Street
Primary Specialty: Driver
Enumeration Date: Apr 26, 2007
Last Updated: Aug 6, 2008

Practice Location

Address: 204 OLD SIAM RD
City: Elizabethton
State: Tennessee
ZIP Code: 37643
Phone: (423) 895-0425

Authorized Official

Name: MR. TIMOTHY JOHN STREET
Title: TRANSPORTATION VENDOR
Phone: (423) 895-0425

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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