Provider Demographics
NPI:1780700757
Name:ZIMMER, CASEY ELIZABETH (OTR)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:ELIZABETH
Last Name:ZIMMER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7818 LISA DR APT 202
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-4232
Mailing Address - Country:US
Mailing Address - Phone:757-963-0832
Mailing Address - Fax:
Practice Address - Street 1:1309 KEMPSVILLE RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2205
Practice Address - Country:US
Practice Address - Phone:757-461-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004395225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist