Provider Demographics
NPI:1912228198
Name:ZERBA CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:ZERBA CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:W
Authorized Official - Last Name:ZERBA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-458-3400
Mailing Address - Street 1:100 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2808
Mailing Address - Country:US
Mailing Address - Phone:520-458-3400
Mailing Address - Fax:520-459-8058
Practice Address - Street 1:100 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2808
Practice Address - Country:US
Practice Address - Phone:520-458-3400
Practice Address - Fax:520-459-8058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ138917Medicare PIN