Provider Demographics
NPI:1437370350
Name:ZOLLMAN CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:ZOLLMAN CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZOLLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-546-8151
Mailing Address - Street 1:200 5TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3116
Mailing Address - Country:US
Mailing Address - Phone:712-546-8151
Mailing Address - Fax:
Practice Address - Street 1:200 5TH AVE NW
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3116
Practice Address - Country:US
Practice Address - Phone:712-546-8151
Practice Address - Fax:712-546-7653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05416111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA07411OtherBCBS PIN
IA1336134659OtherINDIVIDUAL NPI FOR DOCTOR
IA0159376Medicaid
IACLIAOther16D0929683
IA07411Medicare PIN
IACLIAOther16D0929683