Provider Demographics
NPI:1881714038
Name:ZINNEN CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:ZINNEN CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JODI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ZINNEN-NOWAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-241-4500
Mailing Address - Street 1:2100 S CUSTER RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-9701
Mailing Address - Country:US
Mailing Address - Phone:734-241-4500
Mailing Address - Fax:734-241-4602
Practice Address - Street 1:2100 S CUSTER RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-9701
Practice Address - Country:US
Practice Address - Phone:734-241-4500
Practice Address - Fax:734-241-4602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4815050Medicaid
MI95OE810830OtherBLUE CROSS BLUE SHIELD
MIOP14450Medicare ID - Type UnspecifiedMEDICARE
MI4815050Medicaid