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MR. TIMMY JAY AGAN M.S., A.T.,C.

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1225229156

Individual Registrant:
MR. TIMMY JAY AGAN M.S., A.T.,C.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
306 REHOBOTH RD SW  CAVE SPRING, GA 30124-2974 US
Tel: 770-877-1016  Fax: 770-382-8883

Contact information for business:
306 REHOBOTH RD SW  CAVE SPRING, GA 30124-2974 US
Tel: 770-877-1016  Fax: 770-382-8883

Registration Information:
NPI: 1225229156
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
GA000077

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
GEORGIA BOARD OF ATHLETIC0000077GA01




HEALTH CARE JOBS GA - Page 1



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