Mr. Timothy Albert Clark
Massage Therapist
2010 Bonnycastle Ave Apt 1f
Louisville
, Kentucky 40205-1118
Mr. Timothy Albert Clark
Massage Therapist
2010 Bonnycastle Ave Apt 1f
Louisville
, Kentucky 40205-1118
(502) 459-1557
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About
Features
Specialties
- Massage Therapist
Languages spoken
- English
Location
First Address
- Mr. Timothy Albert Clark
- 2010 Bonnycastle Ave Apt 1f
- Louisville, KY
- Zip : 40205-1118
- Phone : (502) 459-1557
Second Address
- Mr. Timothy Albert Clark
- 2010 Bonnycastle Ave Apt 1f
- Louisville, KY
- Zip : 40205-1118
- Phone : (502) 459-1557
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | KY-2716 | KY |
National Provider Identifier
| NPI | 1013233477 |
|---|---|
| Provider Name | Mr. Timothy Albert Clark |
| First Address | Louisville, KY 40205-1118 |
| Second Address | Louisville, KY 40205-1118 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/04/2010 |
| Last Update Date | 10/04/2010 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.