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Individual

TIMOTHEA A MASSART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
1239 W MASON ST, GREEN BAY, WI 54303-2047
(920) 884-6100
(920) 884-6311
Mailing address
1315 W MASON ST, GREEN BAY, WI 54303-2073
(920) 884-6100
(920) 884-6311

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3848-012
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38941700
WI
Enumeration date
03/15/2007
Last updated
12/05/2024
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