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NPI Code Detail

MEDICARE: DR. TIMOTHY WAYNE GUTHMAN D.C.

MEDICARE: DR. TIMOTHY WAYNE GUTHMAN D.C.
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
1111N00000XChiropractor003653MN

General Provider Information

NPI Number : 1376611798
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY WAYNE GUTHMAN D.C.
Provider Business Mailing Address
First Line : 2125 UPPER 55TH ST E
Second Line : SUITE 250
City : INVER GROVE HEIGHTS
State : MN
Zip : 55077-1734
Country : US
Telephone Number : 651-451-3311
Fax Number :
Provider Business Practice Location Address
First Line : 2125 UPPER 55TH ST E
Second Line : SUITE 250
City : INVER GROVE HEIGHTS
State : MN
Zip : 55077-1734
Country : US
Telephone Number : 651-451-3311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 07/08/2007

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