Healthcare Provider Details

I. General information

NPI: 1790441889
Provider Name (Legal Business Name): ZIMMERMAN GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 NW SHEVLIN PARK RD
BEND OR
97703-7195
US

IV. Provider business mailing address

20339 HILLVIEW RD
SAEGERTOWN PA
16433-3947
US

V. Phone/Fax

Practice location:
  • Phone: 541-678-5698
  • Fax:
Mailing address:
  • Phone: 814-450-8454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MELISA ZIMMERMAN
Title or Position: PRESIDENT
Credential: PHD
Phone: 541-678-5698