Healthcare Provider Details

I. General information

NPI: 1598180457
Provider Name (Legal Business Name): LAUREN BAILEY ZIMMEL D.C., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2014
Last Update Date: 04/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1724 EAST BLVD STE 100
CHARLOTTE NC
28203-5995
US

IV. Provider business mailing address

1724 EAST BLVD STE 100
CHARLOTTE NC
28203-5995
US

V. Phone/Fax

Practice location:
  • Phone: 980-237-3424
  • Fax: 980-237-3425
Mailing address:
  • Phone: 980-237-3424
  • Fax: 980-237-3425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4454
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number772
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: