Healthcare Provider Details

I. General information

NPI: 1891988176
Provider Name (Legal Business Name): TARA S ZELLER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 RIVERSIDE AVE SUITE 2
FORT COLLINS CO
80524-4374
US

IV. Provider business mailing address

1301 RIVERSIDE AVE SUITE 2
FORT COLLINS CO
80524-4374
US

V. Phone/Fax

Practice location:
  • Phone: 970-493-4049
  • Fax:
Mailing address:
  • Phone: 970-493-4049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0006986
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License NumberCHR.0006986
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCHR.0006986
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License NumberCHR.0006986
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: