Healthcare Provider Details

I. General information

NPI: 1477942506
Provider Name (Legal Business Name): THIMMEL CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 07/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 N. MIDLAND AVENUE
SADDLE BROOK NJ
07663
US

IV. Provider business mailing address

380 N. MIDLAND AVENUE
SADDLE BROOK NJ
07663
US

V. Phone/Fax

Practice location:
  • Phone: 201-794-6868
  • Fax: 201-794-6003
Mailing address:
  • Phone: 201-794-6868
  • Fax: 201-794-6003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM F THIMMEL
Title or Position: PRESIDENT
Credential: D.C.
Phone: 201-794-6868