MEDICARE: R V ZIMMER, D.C., INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	547	OH

General Provider Information

NPI Number	:	1275724791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R V ZIMMER, D.C., INC

Provider Business Mailing Address
First Line	:	2436 E DOROTHY LN
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45420-1155
Country	:	US
Telephone Number	:	937-294-1484
Fax Number	:	937-294-7542

Provider Business Practice Location Address
First Line	:	2436 E DOROTHY LN
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45420-1155
Country	:	US
Telephone Number	:	937-294-1484
Fax Number	:	937-294-7542

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT V ZIMMER
Credential	:	D.C.
Telephone Number	:	937-294-1484

Provider Enumeration Date	:	08/08/2007
Last Update Date	:	04/20/2008

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