Provider Demographics
NPI:1972186757
Name:DOYLE, ZACHARY NELSON (DPT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:NELSON
Last Name:DOYLE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 CITY WALK DR UNIT 302
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-6944
Mailing Address - Country:US
Mailing Address - Phone:515-314-8852
Mailing Address - Fax:
Practice Address - Street 1:18872 42ND AVE N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-3068
Practice Address - Country:US
Practice Address - Phone:952-807-7312
Practice Address - Fax:833-499-1896
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12157225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist