Provider Demographics
NPI:1689648362
Name:CHOW, TIMOTHY WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:WILLIAM
Last Name:CHOW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1002
Mailing Address - Country:US
Mailing Address - Phone:215-361-1122
Mailing Address - Fax:215-361-6037
Practice Address - Street 1:1970 N BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1002
Practice Address - Country:US
Practice Address - Phone:215-361-1122
Practice Address - Fax:215-361-6037
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2197917000OtherIBX / KHPE PROVIDER ID
PA7598510OtherAETNA PROVIDER ID
PA2197917000OtherIBX / KHPE PROVIDER ID
PA075164Medicare PIN