Provider Demographics
NPI:1891465563
Name:ZEINSTRA, TARA LEE (DC)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:LEE
Last Name:ZEINSTRA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6209 S PINNACLE PL STE 102
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3011
Mailing Address - Country:US
Mailing Address - Phone:605-275-2010
Mailing Address - Fax:
Practice Address - Street 1:6209 S PINNACLE PL STE 102
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3011
Practice Address - Country:US
Practice Address - Phone:605-275-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6845111N00000X
SD1416111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor