Provider Demographics
NPI:1275705907
Name:PAPENDIECK, ZACHARY PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:PATRICK
Last Name:PAPENDIECK
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 1:1037 TRUMAN ST
Mailing Address - Street 2:STE B
Mailing Address - City:KIMBERLY
Mailing Address - State:WI
Mailing Address - Zip Code:54136-2217
Mailing Address - Country:US
Mailing Address - Phone:920-733-3371
Mailing Address - Fax:920-733-3392
Practice Address - Street 1:1037 TRUMAN ST
Practice Address - Street 2:STE B
Practice Address - City:KIMBERLY
Practice Address - State:WI
Practice Address - Zip Code:54136-2217
Practice Address - Country:US
Practice Address - Phone:920-733-3371
Practice Address - Fax:920-733-3392
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4405-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor