Provider Demographics
NPI:1821485814
Name:MILTON CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:MILTON CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:HIDEYO
Authorized Official - Last Name:PICKENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-893-1070
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:VT
Mailing Address - Zip Code:05468-0125
Mailing Address - Country:US
Mailing Address - Phone:802-893-1070
Mailing Address - Fax:802-893-0668
Practice Address - Street 1:165 ROUTE 7 S UNIT 101
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:VT
Practice Address - Zip Code:05468-3605
Practice Address - Country:US
Practice Address - Phone:802-893-1070
Practice Address - Fax:802-893-0668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006.0102119111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty