Individual
TIMOTHY RICHARD MCMULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1508 MISSOURI ROUTE A, SUITE A, LIBERTY, MO 64068-7129
(816) 781-1010
(816) 415-8487
Mailing address
1508 MISSOURI ROUTE A, SUITE A, LIBERTY, MO 64068-7129
(816) 781-1010
(816) 415-8487
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006657
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25314026
BCBS PROVIDER NUMBER
MO
01
—
25314026
BCBS PROVIDER NUMBER
—
01
—
7070138
AETNA PROVIDER #
—
01
—
U70653
HUMANA
MO
Enumeration date
08/07/2007
Last updated
08/07/2007
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