Healthcare Provider Details

I. General information

NPI: 1457590267
Provider Name (Legal Business Name): DZM, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3819 KENTUCKY AVE
INDIANAPOLIS IN
46221-2709
US

IV. Provider business mailing address

3819 KENTUCKY AVE
INDIANAPOLIS IN
46221-2709
US

V. Phone/Fax

Practice location:
  • Phone: 317-856-0880
  • Fax: 317-856-0886
Mailing address:
  • Phone: 317-856-0880
  • Fax: 317-856-0886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001097
License Number StateIN

VIII. Authorized Official

Name: DR. MICHAEL A. WILLIAMS
Title or Position: OWNER
Credential: DC
Phone: 317-856-0880