Provider Demographics
NPI:1437457116
Name:ZUMWALT HILLSBORO CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:ZUMWALT HILLSBORO CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZUMWALT,
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-532-6124
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62049-0597
Mailing Address - Country:US
Mailing Address - Phone:217-532-6124
Mailing Address - Fax:217-532-6414
Practice Address - Street 1:9242 IL RTE #16
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:IL
Practice Address - Zip Code:62049
Practice Address - Country:US
Practice Address - Phone:217-532-6124
Practice Address - Fax:217-532-6414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty