Provider Demographics
NPI:1508846874
Name:SAULSBURY, TIMOTHY (DPT)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:SAULSBURY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 43RD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-8401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:915 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1031
Practice Address - Country:US
Practice Address - Phone:712-234-8760
Practice Address - Fax:712-234-8765
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE42147982000Medicaid
SD5831833Medicaid
IA214940Medicaid
IA650018799OtherRR MEDICARE
IAI1026Medicare UPIN
NE42147982000Medicaid
IA650018799OtherRR MEDICARE
IA650018799Medicare PIN