Provider Demographics
NPI:1841439346
Name:WHELAN, TIMOTHY ROSS (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ROSS
Last Name:WHELAN
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 1:108 WATERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06787-1826
Mailing Address - Country:US
Mailing Address - Phone:860-484-4145
Mailing Address - Fax:
Practice Address - Street 1:108 WATERTOWN RD
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1826
Practice Address - Country:US
Practice Address - Phone:860-484-4145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-07
Last Update Date:2009-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT563111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor