Provider Demographics
NPI:1992897003
Name:SIX, TIMOTHY A (DC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:A
Last Name:SIX
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 1:1424 10TH AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404
Mailing Address - Country:US
Mailing Address - Phone:406-452-6929
Mailing Address - Fax:406-452-1605
Practice Address - Street 1:1424 10TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-2624
Practice Address - Country:US
Practice Address - Phone:406-452-6929
Practice Address - Fax:406-452-1605
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor