Provider Demographics
NPI:1164965810
Name:ANDREW N. TIMAR, DC LLC
Entity Type:Organization
Organization Name:ANDREW N. TIMAR, DC LLC
Other - Org Name:PHOENIXVILLE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:TIMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:484-924-8548
Mailing Address - Street 1:1220 VALLEY FORGE RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2676
Mailing Address - Country:US
Mailing Address - Phone:484-924-8548
Mailing Address - Fax:484-924-9748
Practice Address - Street 1:1220 VALLEY FORGE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2676
Practice Address - Country:US
Practice Address - Phone:484-924-8548
Practice Address - Fax:484-924-9748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherTAX ID