Individual
DR. TIMOTHY PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
809 E LIBERTY ST, YORK, SC 29745-1661
(803) 684-5504
(803) 684-5496
Mailing address
PO BOX 297, YORK, SC 29745-0297
(803) 684-5504
(803) 684-5496
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1366
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386799898
MEDICARE GROUP NPI
SC
05
—
SC1366
—
SC
Enumeration date
07/21/2005
Last updated
01/11/2012
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