Healthcare Provider Details

I. General information

NPI: 1295720639
Provider Name (Legal Business Name): GERALD ALAN ZUKER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 W GRAND RIVER AVE
OKEMOS MI
48864-1701
US

IV. Provider business mailing address

1915 W GRAND RIVER AVE
OKEMOS MI
48864-1701
US

V. Phone/Fax

Practice location:
  • Phone: 517-347-3013
  • Fax: 517-347-2679
Mailing address:
  • Phone: 517-347-3013
  • Fax: 517-347-2679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301004660
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: