Provider Demographics
NPI:1134769532
Name:STETTER, ZACHARY JOHN (DC)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JOHN
Last Name:STETTER
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 1:27 PASCO AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1927
Mailing Address - Country:US
Mailing Address - Phone:812-423-9146
Mailing Address - Fax:
Practice Address - Street 1:915 MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47708-1855
Practice Address - Country:US
Practice Address - Phone:812-423-9146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003142A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor