Moder, Timothy James

Moder, Timothy James is an individual health care provider with primary practice located at 1507 Tower Ave # 307, Superior WI 54880-2532. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Moder, Timothy James can be contacted via phone (715) 392-9300.

Contact Information

Primary practice address
1507 Tower Ave # 307 Superior WI 54880-2532
Phone: (715) 392-9300
Fax: (715) 392-8041
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 14242-130 Wisconsin

Profile Details

NPI number 1437332319
LBN Legal business name Moder, Timothy James
Credentials SAC-IT
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2007
Last updated Dec 13th, 2007 - about 18 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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