Provider Demographics
NPI:1134693435
Name:ZWIEFELHOFER, JOANNA (CMT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:ZWIEFELHOFER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 BUHNE DR SPC 38
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-6874
Mailing Address - Country:US
Mailing Address - Phone:612-209-2607
Mailing Address - Fax:
Practice Address - Street 1:1821 BUHNE DR SPC 38
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-6874
Practice Address - Country:US
Practice Address - Phone:612-209-2607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-20
Last Update Date:2019-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77002225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist