MEDICARE: TIMOTHY JOHN TERSIGNI 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
1	111NN0400X	Neurology Chiropractor	2301008012	MI
2	111NN1001X	Nutrition Chiropractor	2301008012	MI
3	111NR0200X	Radiology Chiropractor	2301008012	MI
4	111N00000X	Chiropractor	2301008012	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	950D750420	OTHER	MI	BCBS PIN

General Provider Information

NPI Number	:	1982671012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY JOHN TERSIGNI D.C.

Provider Business Mailing Address
First Line	:	PO BOX 1126
Second Line	:
City	:	FOWLERVILLE
State	:	MI
Zip	:	48836-1126
Country	:	US
Telephone Number	:	517-223-9276
Fax Number	:	517-223-9278

Provider Business Practice Location Address
First Line	:	746 S GRAND ST
Second Line	:
City	:	FOWLERVILLE
State	:	MI
Zip	:	48836-8901
Country	:	US
Telephone Number	:	517-223-9276
Fax Number	:	517-223-9278

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	03/19/2019

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Directions to “ TIMOTHY JOHN TERSIGNI D.C.” Practice Location

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