Provider Demographics
NPI:1477942506
Name:THIMMEL CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:THIMMEL CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:THIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-794-6868
Mailing Address - Street 1:380 N. MIDLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663
Mailing Address - Country:US
Mailing Address - Phone:201-794-6868
Mailing Address - Fax:201-794-6003
Practice Address - Street 1:380 N. MIDLAND AVENUE
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663
Practice Address - Country:US
Practice Address - Phone:201-794-6868
Practice Address - Fax:201-794-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ147941TMJMedicare UPIN