Healthcare Provider Details

I. General information

NPI: 1912646969
Provider Name (Legal Business Name): TIMOTHY JAMES KOCHER-HILLMER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2022
Last Update Date: 05/28/2022
Certification Date: 05/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 45TH ST
PITTSBURGH PA
15201-2870
US

IV. Provider business mailing address

225 45TH ST
PITTSBURGH PA
15201-2870
US

V. Phone/Fax

Practice location:
  • Phone: 412-621-2472
  • Fax:
Mailing address:
  • Phone: 412-621-2472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMSG003535
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: