Provider Demographics
NPI:1124375449
Name:ZAIDEMAN, MATTHEW RUSH (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:RUSH
Last Name:ZAIDEMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3153 MULBERRY PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-3613
Mailing Address - Country:US
Mailing Address - Phone:850-445-2396
Mailing Address - Fax:
Practice Address - Street 1:1610 W PLAZA DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5324
Practice Address - Country:US
Practice Address - Phone:850-877-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor