TIMOTHY B DIFFERENT

JACKSONVILLE, TX
NPI1730643032
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TX  AP140173)
Enumeration Date2019-01-31
Last Update Date2019-05-21
Business Address
TIMOTHY B DIFFERENT CRNA
2026 S JACKSON ST
JACKSONVILLE, TX 75766-5822
Phone number: 903-586-5678
Mailing Address
TIMOTHY B DIFFERENT CRNA
PO BOX 847522
DALLAS, TX 75284-7522
Phone number: 903-531-5000
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