Provider Demographics
NPI:1609843283
Name:ZWIEFEL, KOREY J (DC)
Entity Type:Individual
Prefix:
First Name:KOREY
Middle Name:J
Last Name:ZWIEFEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S 15TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50428
Mailing Address - Country:US
Mailing Address - Phone:641-357-3393
Mailing Address - Fax:641-357-4228
Practice Address - Street 1:401 S 15TH ST
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE
Practice Address - State:IA
Practice Address - Zip Code:50428
Practice Address - Country:US
Practice Address - Phone:641-357-3393
Practice Address - Fax:641-357-4228
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05999111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1155234Medicaid
IA41833OtherBLUE SHIELD COMMERCIAL
IA58707Medicare ID - Type Unspecified
IA1155234Medicaid