Healthcare Provider Details

I. General information

NPI: 1780860619
Provider Name (Legal Business Name): ZIMMER FAMILY CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9757 WESTPOINT DR STE 500
INDIANAPOLIS IN
46256-3265
US

IV. Provider business mailing address

9757 WESTPOINT DR STE 500
INDIANAPOLIS IN
46256-3265
US

V. Phone/Fax

Practice location:
  • Phone: 317-813-1998
  • Fax: 317-813-1997
Mailing address:
  • Phone: 317-813-1998
  • Fax: 317-813-1997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWARD PAUL ZIMMER
Title or Position: OWNER
Credential: M.S., D.C.
Phone: 317-813-1998