Provider Demographics
NPI:1609893577
Name:KEHRIG, TIMOTHY M (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:M
Last Name:KEHRIG
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 1:1815 S FEDERAL HWY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6991
Mailing Address - Country:US
Mailing Address - Phone:561-737-7787
Mailing Address - Fax:561-737-1131
Practice Address - Street 1:1815 S FEDERAL HWY
Practice Address - Street 2:SUITE 5
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6991
Practice Address - Country:US
Practice Address - Phone:561-737-7787
Practice Address - Fax:561-737-1131
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL007940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor