Healthcare Provider Details

I. General information

NPI: 1932329083
Provider Name (Legal Business Name): JOHN WILLIAM ZENDLER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SCOTT LANE
JACKSON WY
83001
US

IV. Provider business mailing address

PO BOX 10039
JACKSON WY
83002-0039
US

V. Phone/Fax

Practice location:
  • Phone: 307-733-8088
  • Fax: 307-734-8584
Mailing address:
  • Phone: 307-733-8088
  • Fax: 307-734-8584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number569
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: