Provider Demographics
NPI:1881944577
Name:TIMOTHY J ALLARD DC PC
Entity type:Organization
Organization Name:TIMOTHY J ALLARD DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-568-2444
Mailing Address - Street 1:222 REED ST
Mailing Address - Street 2:BOX 135
Mailing Address - City:AKRON
Mailing Address - State:IA
Mailing Address - Zip Code:51001-7740
Mailing Address - Country:US
Mailing Address - Phone:712-568-2444
Mailing Address - Fax:712-568-2445
Practice Address - Street 1:222 REED ST
Practice Address - Street 2:BOX 135
Practice Address - City:AKRON
Practice Address - State:IA
Practice Address - Zip Code:51001-7740
Practice Address - Country:US
Practice Address - Phone:712-568-2444
Practice Address - Fax:712-568-2445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA5069111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0226019Medicaid
IA22601Medicare PIN