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Dr. Timothy John Wolter

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NPI Number Detailed Information

Provider Information:

Name: Dr. Timothy John Wolter
Gender: M
Provider License Number If Given: 26902

NPI Information:

NPI: 1871596825
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 9/28/2007

Provider Business Mailing Address:

Address: 716 WEST COLUMBIA STREET
Chippewa Falls, WI 54729
Phone Number: 7157261963
Fax Number:

Provider Business Practice Location Address:

Address: 716 W COLUMBIA ST
Chippewa Falls, WI 54729
Phone Number: 7157261963
Fax Number:

Provider Taxonomy:

Primary: 207Q00000X
Secondary (if any):
State: WI

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