Provider Demographics
NPI:1912372970
Name:ZIEBELL, GILBERT MATHEW IV (DC)
Entity Type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:MATHEW
Last Name:ZIEBELL
Suffix:IV
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 1:17316 KENYON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-6909
Mailing Address - Country:US
Mailing Address - Phone:952-236-0767
Mailing Address - Fax:
Practice Address - Street 1:17316 KENYON AVE
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-6909
Practice Address - Country:US
Practice Address - Phone:952-236-0767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor