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General NPI Number Information
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NPI Number | 1003037151
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Entity Type | Organization
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Legal Business Name | ZIMMERMANN CHIROPRACTIC AND WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 11/12/2015
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Provider Practice Location Address
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Address Line | 700 LAKE AVE SUITE 3
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City | MANCHESTER
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State | NH
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Zip | 03103-2734
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Country | US
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Telephone | 603-668-7070
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Fax | 603-668-5755
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Provider Business Mailing Address
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Address Line | 700 LAKE AVE SUITE 3
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City | MANCHESTER
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State | NH
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Zip | 03103-2734
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Country | US
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Telephone | 603-668-7070
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Fax | 603-668-5755
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEITH JOHN ZIMMERMANN
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Credential | DC
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Telephone | 603-668-7070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 1000492
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License Number State | NH
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