Provider Demographics
NPI:1962647693
Name:ZIMMERMAN.PRO LLC
Entity Type:Organization
Organization Name:ZIMMERMAN.PRO LLC
Other - Org Name:THE BIRTH CHIRO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-895-8899
Mailing Address - Street 1:9817 E 37TH CT
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-2401
Mailing Address - Country:US
Mailing Address - Phone:918-895-8899
Mailing Address - Fax:918-512-4442
Practice Address - Street 1:3336 E 32ND ST STE 103
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-4446
Practice Address - Country:US
Practice Address - Phone:918-895-8899
Practice Address - Fax:918-512-4442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1235355850OtherNPI OF OWNER