Healthcare Provider Details

I. General information

NPI: 1891147518
Provider Name (Legal Business Name): KAZIMIERA JOSEPHINE ZIPPERT DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 06/09/2020
Certification Date: 06/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6177 LAKE ST
KINGSVILLE OH
44048-9703
US

IV. Provider business mailing address

PO BOX 62
KINGSVILLE OH
44048-0062
US

V. Phone/Fax

Practice location:
  • Phone: 330-963-2273
  • Fax:
Mailing address:
  • Phone: 440-224-0680
  • Fax: 440-224-2888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4636
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: