Provider Demographics
NPI:1801033089
Name:ZIMMER, JOSH (AP, DOM)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:ZIMMER
Suffix:
Gender:M
Credentials:AP, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 ROBINHOOD ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-3620
Mailing Address - Country:US
Mailing Address - Phone:941-330-5355
Mailing Address - Fax:
Practice Address - Street 1:1910 ROBINHOOD ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-3620
Practice Address - Country:US
Practice Address - Phone:941-330-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2637171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist