Healthcare Provider Details

I. General information

NPI: 1639375553
Provider Name (Legal Business Name): ZIMMER CHIROPRACTIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 E VETERANS MEMORIAL HWY
KASSON MN
55944-1201
US

IV. Provider business mailing address

15 E VETERANS MEMORIAL HWY
KASSON MN
55944-1201
US

V. Phone/Fax

Practice location:
  • Phone: 507-634-6677
  • Fax: 507-634-6688
Mailing address:
  • Phone: 507-634-6677
  • Fax: 507-634-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4272
License Number StateMN

VIII. Authorized Official

Name: DR. NEIL JEROME ZIMMER
Title or Position: PRESIDENT
Credential: DC
Phone: 507-634-6677