Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Timothy Aaron Stanley Fracassi, LAT

Individual provider Athletic Trainer · NPI 1629474648

Timothy Aaron Stanley Fracassi, LAT is an Athletic Trainer in Southfield, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2014
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

28650 Lahser Rd
Southfield, MI 48034-2020
Phone: (248) 789-1068
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2601000720 (MI)

Record details

NPI number1629474648
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT
Sole proprietorYes
NPI enumeratedNovember 18, 2014
Last updated in NPPESNovember 18, 2014

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