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Individual

DR. PETER S TIMKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
2735 W UNION HILLS DR, STE 102, PHOENIX, AZ 85027-5033
(602) 973-1630
(602) 973-1667
Mailing address
2735 W UNION HILLS DR, STE 102, PHOENIX, AZ 85027-5033
(602) 973-1630
(602) 973-1667

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
AZ05748
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Z72964
MC ORGANIZATIONAL PROV ID
AZ
01
Z72965
MC PROVIDER INDIVIDUAL ID
AZ
Enumeration date
12/14/2007
Last updated
08/09/2012
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