Provider Demographics
NPI:1013045285
Name:NIGUS, ZACKARY ALAN (DC , FASA)
Entity Type:Individual
Prefix:DR
First Name:ZACKARY
Middle Name:ALAN
Last Name:NIGUS
Suffix:
Gender:M
Credentials:DC , FASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5929 E 150TH ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:MO
Mailing Address - Zip Code:64030-4364
Mailing Address - Country:US
Mailing Address - Phone:913-963-2812
Mailing Address - Fax:
Practice Address - Street 1:100 JOHNSTOWN CENTER DR
Practice Address - Street 2:STE. A
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-9000
Practice Address - Country:US
Practice Address - Phone:970-587-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6031111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor