Provider Demographics
NPI:1619314648
Name:ZIMMERMAN UPPER CERVICAL CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:ZIMMERMAN UPPER CERVICAL CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KILEY
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-430-4636
Mailing Address - Street 1:7504 1/2 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-5003
Mailing Address - Country:US
Mailing Address - Phone:319-277-1679
Mailing Address - Fax:
Practice Address - Street 1:7504 1/2 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-5003
Practice Address - Country:US
Practice Address - Phone:319-277-1679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty