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General NPI Number Information
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NPI Number | 1174904213
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Entity Type | Organization
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Legal Business Name | DR TIMOTHY WHELAN
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 235 E 2ND AVE
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City | MILBANK
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State | SD
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Zip | 57252-1814
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Country | US
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Telephone | 605-432-9070
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Fax | 605-432-9070
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Provider Business Mailing Address
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Address Line | 235 E 2ND AVE
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City | MILBANK
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State | SD
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Zip | 57252-1814
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Country | US
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Telephone | 605-432-9070
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Fax | 605-432-9070
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. TIMOTHY JOHN WHELAN
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Credential | DC
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Telephone | 605-432-9070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1006
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License Number State | SD
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