MEDICARE: TYMBREE BATY DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	113077	IA

General Provider Information

NPI Number	:	1205583424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYMBREE BATY DC

Provider Business Mailing Address
First Line	:	2011 RIDGEVIEW DR
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52806-1146
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11675 RIDGELINE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-3992
Country	:	US
Telephone Number	:	719-520-4988
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2022
Last Update Date	:	09/18/2025

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