Provider Demographics
NPI:1407315914
Name:EISIMINGER, ZACHARY PALMER
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:PALMER
Last Name:EISIMINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 1/2 N RICHHILL ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-1124
Mailing Address - Country:US
Mailing Address - Phone:724-833-7431
Mailing Address - Fax:
Practice Address - Street 1:51 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1258
Practice Address - Country:US
Practice Address - Phone:724-833-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer