Provider Demographics
NPI:1568553121
Name:ZOELLER, MARK R (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:R
Last Name:ZOELLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:D
Other - Last Name:ZOELLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:2900 SW ATWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2857
Mailing Address - Country:US
Mailing Address - Phone:785-272-5844
Mailing Address - Fax:785-272-5846
Practice Address - Street 1:2900 SW ATWOOD AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2857
Practice Address - Country:US
Practice Address - Phone:785-272-5844
Practice Address - Fax:785-272-5846
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0103831111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS007404Medicare ID - Type UnspecifiedDR. MARK ZOELLER
KS007393Medicare ID - Type UnspecifiedDR. ROBERT ZOELLER