Provider Demographics
NPI:1982671012
Name:TERSIGNI, TIMOTHY JOHN (DC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JOHN
Last Name:TERSIGNI
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:PO BOX 1126
Mailing Address - Street 2:
Mailing Address - City:FOWLERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48836-1126
Mailing Address - Country:US
Mailing Address - Phone:517-223-9276
Mailing Address - Fax:517-223-9278
Practice Address - Street 1:746 S GRAND ST
Practice Address - Street 2:
Practice Address - City:FOWLERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48836-8901
Practice Address - Country:US
Practice Address - Phone:517-223-9276
Practice Address - Fax:517-223-9278
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008012111NN0400X, 111NN1001X, 111NR0200X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0200XChiropractic ProvidersChiropractorRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950D750420OtherBCBS PIN
MION50680Medicare ID - Type Unspecified