Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 898 | WV |
NPI | 1154588598 |
---|---|
Provider Name | Dr. Timothy Patrick Dorey JR. |
First Address | Morgantown, WV 26508 |
Second Address | Morgantown, WV 26508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2008 |
Last Update Date | 27/03/2015 |