Kiley, Timothy Campbell

Kiley, Timothy Campbell is an individual health care provider with primary practice located at 377 W Broadway , South Boston MA 02127-2217. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Kiley, Timothy Campbell can be contacted via phone (617) 752-4672.

Contact Information

Primary practice address
377 W Broadway South Boston MA 02127-2217
Phone: (617) 752-4672
Fax: (617) 752-4643
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 17617 Massachusetts

Profile Details

NPI number 1245418235
LBN Legal business name Kiley, Timothy Campbell
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2008
Last updated Apr 26th, 2017 - about 8 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 1245418235 NPPES
Massachusetts MEDICAID 110087951A

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