Provider Demographics
NPI:1376628123
Name:RAMOS, TIMOTHY NICK SR (BS,DC,LAC,FIAMA)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:NICK
Last Name:RAMOS
Suffix:SR
Gender:M
Credentials:BS,DC,LAC,FIAMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 N CENTRAL PKWY SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6816
Mailing Address - Country:US
Mailing Address - Phone:256-353-7576
Mailing Address - Fax:256-353-7517
Practice Address - Street 1:1711 N CENTRAL PKWY SW
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6816
Practice Address - Country:US
Practice Address - Phone:256-353-7576
Practice Address - Fax:256-353-7517
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51074746Medicare UPIN
ALU43858Medicare ID - Type Unspecified