Healthcare Provider Details

I. General information

NPI: 1467601724
Provider Name (Legal Business Name): JESSICA ZIKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1334 W 26TH ST
ERIE PA
16508-1402
US

IV. Provider business mailing address

1334 W 26TH ST
ERIE PA
16508-1402
US

V. Phone/Fax

Practice location:
  • Phone: 814-459-2580
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2165
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC010963
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberAJ010735
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: