Provider Demographics
NPI:1679075501
Name:ZUKER CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ZUKER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZUKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-347-3013
Mailing Address - Street 1:1915 W GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-1701
Mailing Address - Country:US
Mailing Address - Phone:517-347-3013
Mailing Address - Fax:517-347-2679
Practice Address - Street 1:1915 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1701
Practice Address - Country:US
Practice Address - Phone:517-347-3013
Practice Address - Fax:517-347-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty