MEDICARE: P SCOTT TIMKO DC PLLC

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	5748	AZ

General Provider Information

NPI Number	:	1528032869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	P SCOTT TIMKO DC PLLC

Provider Business Mailing Address
First Line	:	2814 W BELL RD
Second Line	:	STE 1470
City	:	PHOENIX
State	:	AZ
Zip	:	85053
Country	:	US
Telephone Number	:	602-863-3345
Fax Number	:	602-863-0949

Provider Business Practice Location Address
First Line	:	2814 W BELL RD
Second Line	:	STE 1470
City	:	PHOENIX
State	:	AZ
Zip	:	85053
Country	:	US
Telephone Number	:	602-863-3345
Fax Number	:	602-863-0949

Authorized Official
Title or Position	:	OWNER
Name	:	DR. P SCOTT TIMKO
Credential	:	DC
Telephone Number	:	602-863-3345

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	02/08/2008

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