Provider Demographics
NPI:1881870897
Name:ZIKA, JACOB WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:WILLIAM
Last Name:ZIKA
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 1:17652 KENWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-9764
Mailing Address - Country:US
Mailing Address - Phone:952-595-6325
Mailing Address - Fax:952-595-6326
Practice Address - Street 1:17652 KENWOOD TRL
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-9764
Practice Address - Country:US
Practice Address - Phone:952-595-6325
Practice Address - Fax:952-595-6326
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5402111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor