Provider Demographics
NPI:1033316831
Name:ZIMMERMAN, AMY J (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:J
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 MARGARET ST
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:WI
Mailing Address - Zip Code:53553-9792
Mailing Address - Country:US
Mailing Address - Phone:608-574-4192
Mailing Address - Fax:
Practice Address - Street 1:605 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:WI
Practice Address - Zip Code:53543
Practice Address - Country:US
Practice Address - Phone:608-929-4200
Practice Address - Fax:608-929-4201
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4278-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor