Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO4416 | FL |
NPI | 1023190568 |
---|---|
Provider Name | Timothy Lavon Helms |
First Address | Tallahassee, FL 32308-4334 |
Second Address | Tallahassee, FL 32308-4334 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 08/07/2007 |