Kistler, Timothy J

Kistler, Timothy J is an individual health care provider with primary practice located at 111 Willard St Ste 2A , Quincy MA 02169-1274. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Sports Physician, Chiropractic Providers / Chiropractor. Chiropractic Providers / Chiropractor is his primary health care specialty. Kistler, Timothy J can be contacted via phone (617) 804-7464.

Contact Information

Primary practice address
111 Willard St Ste 2A Quincy MA 02169-1274
Phone: (617) 804-7464
Fax: (617) 471-1114
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Sports Physician 111NS0005X 08001237 Indiana
Chiropractic Providers / Chiropractor 111N00000X 3594 Massachusetts

Profile Details

NPI number 1043366347
LBN Legal business name Kistler, Timothy J
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2007
Last updated May 25th, 2021 - about 3 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 1043366347 NPPES
Indiana Other P00006924 RAILROAD MEDICARE
Indiana Other 000000344943 RAILROAD MEDICARE
Indiana MEDICAID 200077400A RAILROAD MEDICARE
Indiana Other AETNA RAILROAD MEDICARE
Indiana Other 6904776002 RAILROAD MEDICARE

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