Provider Demographics
NPI:1326140401
Name:SAULTER, TIMOTHY E (DC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:E
Last Name:SAULTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 NARROW GAUGE SQ
Mailing Address - Street 2:STE 102
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938
Mailing Address - Country:US
Mailing Address - Phone:207-778-6464
Mailing Address - Fax:207-778-0011
Practice Address - Street 1:116 NARROW GAUGE SQ
Practice Address - Street 2:STE 102
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938
Practice Address - Country:US
Practice Address - Phone:207-778-6464
Practice Address - Fax:207-778-0011
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME002319OtherANTHEM
MEMM4486Medicare ID - Type Unspecified
ME002319OtherANTHEM