MEDICARE: BRADLEY T ZINKEL D.C.

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	4766-12	WI

General Provider Information

NPI Number	:	1699063024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY T ZINKEL D.C.

Provider Business Mailing Address
First Line	:	312 E NORTH ST
Second Line	:
City	:	DE FOREST
State	:	WI
Zip	:	53532-1258
Country	:	US
Telephone Number	:	608-846-3333
Fax Number	:	608-846-3032

Provider Business Practice Location Address
First Line	:	312 E NORTH ST
Second Line	:
City	:	DE FOREST
State	:	WI
Zip	:	53532-1258
Country	:	US
Telephone Number	:	608-846-3333
Fax Number	:	608-846-3032

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2011
Last Update Date	:	07/19/2011

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Directions to “ BRADLEY T ZINKEL D.C.” Practice Location

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