Henderson, Timothy James

Henderson, Timothy James is an sole proprietor health care provider with primary practice located at 610 East Blvd , Rapid City SD 57701-2902. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Henderson, Timothy James can be contacted via phone (605) 342-3908.

Contact Information

Primary practice address
610 East Blvd Rapid City SD 57701-2902
Phone: (605) 342-3908
Fax: (605) 342-0250
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 1055 South Dakota

Profile Details

NPI number 1174571780
LBN Legal business name Henderson, Timothy James
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 5th, 2006
Last updated Mar 31st, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174571780 NPPES
South Dakota Other 4994541 WELLMARK
South Dakota Other 48322 WELLMARK
South Dakota Other 13959 WELLMARK
South Dakota Other 249390 WELLMARK
South Dakota MEDICAID 7602530 WELLMARK

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