Healthcare Provider Details

I. General information

NPI: 1063585339
Provider Name (Legal Business Name): JEFFREY A ZIPP DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7115 LAKE WORTH RD
LAKE WORTH FL
33467-2906
US

IV. Provider business mailing address

7115 LAKE WORTH RD
LAKE WORTH FL
33467-2906
US

V. Phone/Fax

Practice location:
  • Phone: 561-318-7432
  • Fax: 561-429-8983
Mailing address:
  • Phone: 561-318-7432
  • Fax: 561-429-8983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH0005593
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: