Healthcare Provider Details

I. General information

NPI: 1437457116
Provider Name (Legal Business Name): ZUMWALT HILLSBORO CHIROPRACTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2011
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9242 IL RTE #16
HILLSBORO IL
62049
US

IV. Provider business mailing address

PO BOX 597
HILLSBORO IL
62049-0597
US

V. Phone/Fax

Practice location:
  • Phone: 217-532-6124
  • Fax: 217-532-6414
Mailing address:
  • Phone: 217-532-6124
  • Fax: 217-532-6414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. GERALD L. ZUMWALT,
Title or Position: PRESIDENT/DOCTOR
Credential: DC
Phone: 217-532-6124