Healthcare Provider Details

I. General information

NPI: 1871779918
Provider Name (Legal Business Name): WARREN JOSEPH ZOOK D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2008
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HIGHWAY 25 N STE 102
BUFFALO MN
55313-1948
US

IV. Provider business mailing address

1111 HIGHWAY 25 N STE 102
BUFFALO MN
55313-1948
US

V. Phone/Fax

Practice location:
  • Phone: 763-600-1111
  • Fax:
Mailing address:
  • Phone: 763-600-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC4133
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: