Healthcare Provider Details

I. General information

NPI: 1144692146
Provider Name (Legal Business Name): TIMOTHY JOSHUA ZITTLE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 03/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6677 DUBLIN CENTER DR
DUBLIN OH
43017-5077
US

IV. Provider business mailing address

2049 GLIDDON CT
COLUMBUS OH
43235-2023
US

V. Phone/Fax

Practice location:
  • Phone: 614-300-0759
  • Fax:
Mailing address:
  • Phone: 614-300-0759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4691
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: