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General NPI Number Information
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NPI Number | 1124375449
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Entity Type | Individual
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Provider Name | MATTHEW RUSH ZAIDEMAN D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 1610 W PLAZA DR
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5324
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Country | US
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Telephone | 850-877-6790
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Fax |
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Provider Business Mailing Address
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Address Line | 3153 MULBERRY PARK BLVD
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City | TALLAHASSEE
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State | FL
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Zip | 32311-3613
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Country | US
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Telephone | 850-445-2396
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH10713
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License Number State | FL
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