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NPI Code Detail

MEDICARE: DR. TIMOTHY JAMES BELLEAU BS DC CCSP CKTP

MEDICARE:  DR. TIMOTHY JAMES BELLEAU  BS DC CCSP CKTP
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
1111N00000XChiropractor2670012WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144308578
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY JAMES BELLEAU BS DC CCSP CKTP
Provider Business Mailing Address
First Line : 825 S HURON RD
Second Line : SUITE H
City : GREEN BAY
State : WI
Zip : 54311-8049
Country : US
Telephone Number : 920-406-8700
Fax Number : 920-406-8712
Provider Business Practice Location Address
First Line : 825 S HURON RD
Second Line : SUITE H
City : GREEN BAY
State : WI
Zip : 54311-8049
Country : US
Telephone Number : 920-406-8700
Fax Number : 920-406-8712
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 11/24/2015

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Directions to “ DR. TIMOTHY JAMES BELLEAU BS DC CCSP CKTP” Practice Location

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