Provider Demographics
NPI:1558462606
Name:SEGREE, ZOE (DC)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:
Last Name:SEGREE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 US HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:EASTPOINT
Mailing Address - State:FL
Mailing Address - Zip Code:32328-3572
Mailing Address - Country:US
Mailing Address - Phone:850-670-5494
Mailing Address - Fax:850-670-1424
Practice Address - Street 1:661 US HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:EASTPOINT
Practice Address - State:FL
Practice Address - Zip Code:32328-3572
Practice Address - Country:US
Practice Address - Phone:850-670-5494
Practice Address - Fax:850-670-1424
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381988400Medicaid
FLU51239Medicare UPIN
FL381988400Medicaid