Individual
DR. JILL R TIEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
671 MONTAUK HWY, SUITE A, BAYPORT, NY 11705-1607
(631) 472-1095
(631) 472-8221
Mailing address
671 MONTAUK HWY, SUITE A, BAYPORT, NY 11705-1607
(631) 472-1095
(631) 472-8221
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
XOO 6115-1
NY
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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