Provider Demographics
NPI:1851936900
Name:ZAM, LOUIS KORY (DC)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:KORY
Last Name:ZAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9125 QUADAY AVE NE STE 102
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-6662
Mailing Address - Country:US
Mailing Address - Phone:763-274-0373
Mailing Address - Fax:763-274-0375
Practice Address - Street 1:9125 QUADAY AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-6662
Practice Address - Country:US
Practice Address - Phone:763-274-0373
Practice Address - Fax:763-274-0375
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor