NPI 1053077024

Timothy John Stephens

Practitioner Home Modifications Contractor Big Lake, MN

Practice location

Address: 22251 169th St NW, Big Lake, MN 55309-8220
Phone: (612) 710-8451

Registered specialties

Home Modifications Contractor Primary

Other Service Providers Taxonomy 171WH0202X Licence BC767187 (MN)

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Registry record

NPI: 1053077024
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Nov 2021
Record last updated: 13 Nov 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.