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Individual
DR. TIMOTHY DARYLL DEBOARD
Active
Individual
DR. TIMOTHY DARYLL DEBOARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301007577
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44-30215
PHP
MI
01
—
950G510810
BCN ID
MI
Enumeration date
05/01/2006
Last updated
06/19/2008
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