Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 343 | MT |
NPI | 1659437382 |
---|---|
Provider Name | Mr. Timothy A Binder |
First Address | Hamilton, MT 59840 |
Second Address | Hamilton, MT 59840-9314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 08/07/2007 |