Provider Demographics
NPI:1851433304
Name:ZELLER & JOHNSON CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:ZELLER & JOHNSON CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ZELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-723-3144
Mailing Address - Street 1:1109 E PARKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:MANISTEE
Mailing Address - State:MI
Mailing Address - Zip Code:49660-9704
Mailing Address - Country:US
Mailing Address - Phone:231-723-3144
Mailing Address - Fax:231-723-3140
Practice Address - Street 1:1109 E PARKDALE AVE
Practice Address - Street 2:
Practice Address - City:MANISTEE
Practice Address - State:MI
Practice Address - Zip Code:49660-9704
Practice Address - Country:US
Practice Address - Phone:231-723-3144
Practice Address - Fax:231-723-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2012-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007649111N00000X
MI2301007632111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E11016OtherBCBS GROUP NUMBER
MI0E11016OtherBCBS GROUP NUMBER