Provider Demographics
NPI:1730401852
Name:TIMS, ELNA M (CMT)
Entity type:Individual
Prefix:
First Name:ELNA
Middle Name:M
Last Name:TIMS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:203 COOPER AVE N
Mailing Address - Street 2:SUITE# 160
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4446
Mailing Address - Country:US
Mailing Address - Phone:320-310-4000
Mailing Address - Fax:320-253-1575
Practice Address - Street 1:203 COOPER AVE N
Practice Address - Street 2:SUITE# 160
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4446
Practice Address - Country:US
Practice Address - Phone:320-310-4000
Practice Address - Fax:320-253-1575
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist