Individual
DR. TIMOTHY J KISTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
111 WILLARD ST STE 2A, QUINCY, MA 02169-1274
(617) 804-7464
(617) 471-1114
Mailing address
703 GRANITE ST, STE 3, BRAINTREE, MA 02184-5350
(317) 826-2273
(317) 826-2673
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3594
MA
111NS0005X
Sports Physician Chiropractor
08001237
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000344943
BCBS
IN
05
—
200077400A
—
IN
01
—
6904776002
CIGNA
IN
01
—
AETNA
4351909
IN
01
—
P00006924
RAILROAD MEDICARE
IN
Enumeration date
01/27/2007
Last updated
05/25/2021
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