Healthcare Provider Details

I. General information

NPI: 1720405525
Provider Name (Legal Business Name): CHIRIN ZEAITER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 03/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 WILSON AVE SW
CEDAR RAPIDS IA
52404-6380
US

IV. Provider business mailing address

1745 5TH ST APT 2
CORALVILLE IA
52241-1883
US

V. Phone/Fax

Practice location:
  • Phone: 319-396-6838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number007729
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: