Most Relevant Information
Provider Data
| NPI Number: | 1003645193 |
| Provider Name: | TIMOTHY RASHID FITZGERALD |
| Entity Type: | Individual |
| Taxonomy Code: | 251S00000X |
| Specialty: | Community/Behavioral Health |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/29/2024 |
| Last Updated: | 07/29/2024 |
Provider Practice Location
2211 LAKE CLUB DR STE 105
COLUMBUS
OH
432323204
Practice Location Phone/Fax
| Phone: | 3305075129 |
| Fax: |
Provider Mailing Location
2211 LAKE CLUB DR STE 105
COLUMBUS
OH
432323204
Provider Mailing Phone/Fax
| Phone: | 3305075129 |
| Fax: |