Provider Demographics
NPI:1306978515
Name:ZIMMERMAN CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:ZIMMERMAN CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-795-8898
Mailing Address - Street 1:349 FOLLY RD
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2508
Mailing Address - Country:US
Mailing Address - Phone:843-795-8898
Mailing Address - Fax:843-795-8823
Practice Address - Street 1:349 FOLLY RD
Practice Address - Street 2:SUITE 2C
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2508
Practice Address - Country:US
Practice Address - Phone:843-795-8898
Practice Address - Fax:843-795-8823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU691820281Medicare ID - Type Unspecified