Provider Demographics
NPI:1255572269
Name:GREENWOOD, TIMOTHY HALLIE JR (DC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:HALLIE
Last Name:GREENWOOD
Suffix:JR
Gender:M
Credentials:DC
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Mailing Address - Street 1:1022 WEISS STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-1952
Mailing Address - Country:US
Mailing Address - Phone:989-652-3244
Mailing Address - Fax:989-652-6437
Practice Address - Street 1:1022 WEISS STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-1952
Practice Address - Country:US
Practice Address - Phone:989-652-3244
Practice Address - Fax:989-652-6437
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2014-07-24
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Provider Licenses
StateLicense IDTaxonomies
MI2301009547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI261557851OtherCOFINITY-PPOM
MI200000021511OtherPHYSICIANS HEALTH PLAN
MI01019982OtherHEALTHPLUS
MI9712364OtherAETNA