Provider Demographics
NPI:1093990285
Name:ZWIEFEL CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:ZWIEFEL CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KOREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZWIEFEL
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DC
Authorized Official - Phone:6413-573-3933
Mailing Address - Street 1:401 S 15TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50428-2303
Mailing Address - Country:US
Mailing Address - Phone:641-357-3393
Mailing Address - Fax:641-357-4228
Practice Address - Street 1:401 S 15TH ST
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE
Practice Address - State:IA
Practice Address - Zip Code:50428-2303
Practice Address - Country:US
Practice Address - Phone:641-357-3393
Practice Address - Fax:641-357-4228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05999111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1155234Medicaid
IA1609843283OtherINDIVIDUAL NPI
IAU65396Medicare UPIN