Provider Demographics
NPI:1134281348
Name:ZIMMERMAN, CHRISTOPHER CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:CHARLES
Last Name:ZIMMERMAN
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 1:800 S 50TH ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-5381
Mailing Address - Country:US
Mailing Address - Phone:515-225-7979
Mailing Address - Fax:515-225-2162
Practice Address - Street 1:4800 MILLS CIVIC PKWY STE 104
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-5264
Practice Address - Country:US
Practice Address - Phone:515-225-7979
Practice Address - Fax:515-225-2162
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06651111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAU97906Medicare UPIN
IAI10871Medicare ID - Type Unspecified