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:
Health care specialties
| Specialty | Code | License # | 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 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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