Provider Demographics
NPI:1043804115
Name:PLACE, ZACHARIAH E
Entity Type:Individual
Prefix:
First Name:ZACHARIAH
Middle Name:E
Last Name:PLACE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-1673
Mailing Address - Country:US
Mailing Address - Phone:304-476-5880
Mailing Address - Fax:
Practice Address - Street 1:606 ELM ST
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1673
Practice Address - Country:US
Practice Address - Phone:304-476-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker