MEDICARE: TIMOTHY MOLITORIS

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
1	111N00000X	Chiropractor	3298	MA

General Provider Information

NPI Number	:	1154576460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY MOLITORIS

Provider Business Mailing Address
First Line	:	PO BOX 453
Second Line	:
City	:	EASTHAMPTON
State	:	MA
Zip	:	01027-0453
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	32 MASONIC ST
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-3587
Country	:	US
Telephone Number	:	413-570-0438
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2008
Last Update Date	:	01/20/2015

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Directions to “ TIMOTHY MOLITORIS ” Practice Location

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