Provider Demographics
NPI:1881976421
Name:ZACHARY R KORTH DC PC
Entity type:Organization
Organization Name:ZACHARY R KORTH DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:KORTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-369-1498
Mailing Address - Street 1:5421 N 103RD ST
Mailing Address - Street 2:SUITE NUMBER 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1000
Mailing Address - Country:US
Mailing Address - Phone:402-493-1722
Mailing Address - Fax:402-493-1755
Practice Address - Street 1:5421 N 103RD ST
Practice Address - Street 2:SUITE NUMBER 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-1000
Practice Address - Country:US
Practice Address - Phone:402-493-1722
Practice Address - Fax:402-493-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty