Healthcare Provider Details

I. General information

NPI: 1487781266
Provider Name (Legal Business Name): STANLEY ROBERT ZIVANOVICH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 SWATARA ST
STEELTON PA
17113-2450
US

IV. Provider business mailing address

541 SWATARA ST
STEELTON PA
17113-2450
US

V. Phone/Fax

Practice location:
  • Phone: 717-939-5173
  • Fax: 717-939-4743
Mailing address:
  • Phone: 717-939-5173
  • Fax: 717-939-4743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-002354-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: