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General NPI Number Information
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NPI Number | 1407313547
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Entity Type | Individual
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Provider Name | TIMOTHY JOHN HILLIS DC
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Gender | Male
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 126 N MAIN ST
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City | PIEDMONT
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State | MO
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Zip | 63957-1255
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Country | US
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Telephone | 573-223-2393
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Fax |
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Provider Business Mailing Address
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Address Line | 126 N MAIN ST
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City | PIEDMONT
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State | MO
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Zip | 63957-1255
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Country | US
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Telephone | 573-223-2393
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 038.013334
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2021001021
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License Number State | MO
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