Provider Demographics
NPI:1427228808
Name:PAUL, ZACHARY J (DC)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:J
Last Name:PAUL
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 1:6214 STATE HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR
Mailing Address - State:WI
Mailing Address - Zip Code:54209-9135
Mailing Address - Country:US
Mailing Address - Phone:920-256-2865
Mailing Address - Fax:608-441-1981
Practice Address - Street 1:6214 STATE HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:EGG HARBOR
Practice Address - State:WI
Practice Address - Zip Code:54209-9135
Practice Address - Country:US
Practice Address - Phone:920-256-2865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4387-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38187000Medicaid
WI38187000Medicaid