Healthcare Provider Details

I. General information

NPI: 1073670485
Provider Name (Legal Business Name): KRISTY LEE ZINNES DOWNEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 BURRILL ST
SWAMPSCOTT MA
01907-1835
US

IV. Provider business mailing address

186 BURRILL ST
SWAMPSCOTT MA
01907-1835
US

V. Phone/Fax

Practice location:
  • Phone: 781-593-2399
  • Fax:
Mailing address:
  • Phone: 781-593-2388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC30386
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3431
License Number StateMA

VII. Legacy identifiers

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

# 1
IdentifierDC30386
Identifier TypeOTHER
Identifier StateCA
Identifier IssuerCALIFORNIA BOARD OF CHIROPRACTIC
# 2
Identifier3431
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerMASSACHUSETTS BOARD OF CHHIROPRACTIC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: