Individual
TIMOTHY J O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2021 S ONEIDA ST, APPLETON, WI 54915-4945
(920) 735-2828
(920) 735-2981
Mailing address
2021 S ONEIDA ST, APPLETON, WI 54915-4945
(920) 735-2828
(920) 735-2981
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2261
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38841000
—
WI
01
—
391936002008
BLUE CROSS BLUE SHIELD
—
Enumeration date
09/04/2006
Last updated
07/09/2007
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