Provider Demographics
NPI:1447426358
Name:ZOLMAN CHIROPRACTIC CLINIC PLLC
Entity Type:Organization
Organization Name:ZOLMAN CHIROPRACTIC CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-787-1918
Mailing Address - Street 1:210 G ST SE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:WA
Mailing Address - Zip Code:98848-1556
Mailing Address - Country:US
Mailing Address - Phone:509-787-1918
Mailing Address - Fax:509-787-3140
Practice Address - Street 1:210 G ST SE
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:WA
Practice Address - Zip Code:98848-1556
Practice Address - Country:US
Practice Address - Phone:509-787-1918
Practice Address - Fax:509-787-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602024651261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center