Provider Demographics
NPI:1669199840
Name:TIMOTHY S MELTON DC PC
Entity type:Organization
Organization Name:TIMOTHY S MELTON DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:325-261-1640
Mailing Address - Street 1:4601 BUFFALO GAP RD STE C1
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-3363
Mailing Address - Country:US
Mailing Address - Phone:325-261-1640
Mailing Address - Fax:325-480-1261
Practice Address - Street 1:4601 BUFFALO GAP RD STE C1
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-3363
Practice Address - Country:US
Practice Address - Phone:325-261-1640
Practice Address - Fax:325-480-1261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty