Kiley, Timothy Campbell
Kiley, Timothy Campbell is an individual health care provider with primary practice located at 377 W Broadway , South Boston MA 02127-2217. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Kiley, Timothy Campbell can be contacted via phone (617) 752-4672.Contact Information
Primary practice address
377 W Broadway
South Boston MA 02127-2217
Phone: (617) 752-4672
Fax: (617) 752-4643
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 17617 | Massachusetts |
Profile Details
| NPI number | 1245418235 |
|---|---|
| LBN Legal business name | Kiley, Timothy Campbell |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2008 |
| Last updated | Apr 26th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245418235 | NPPES |
| Massachusetts | MEDICAID | 110087951A |
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