Provider Demographics
NPI:1124025259
Name:ABERSON, TIMOTHY TODD (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:TODD
Last Name:ABERSON
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:PO BOX 301
Mailing Address - Street 2:
Mailing Address - City:PAULLINA
Mailing Address - State:IA
Mailing Address - Zip Code:51046-0301
Mailing Address - Country:US
Mailing Address - Phone:712-898-9053
Mailing Address - Fax:
Practice Address - Street 1:307 S CENTER ST
Practice Address - Street 2:
Practice Address - City:PAULLINA
Practice Address - State:IA
Practice Address - Zip Code:51046-7803
Practice Address - Country:US
Practice Address - Phone:712-949-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05643111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA10829Medicare ID - Type Unspecified
IAU35150Medicare UPIN