Provider Demographics
NPI:1659523306
Name:ZIMET, NICHOLAS (LAC)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:ZIMET
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 4TH AVE S STE 208
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2465
Mailing Address - Country:US
Mailing Address - Phone:612-961-4919
Mailing Address - Fax:612-437-4919
Practice Address - Street 1:2929 4TH AVE S
Practice Address - Street 2:SUITE 206
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2460
Practice Address - Country:US
Practice Address - Phone:612-961-4919
Practice Address - Fax:612-437-4919
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1467171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist