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General NPI Number Information
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NPI Number | 1487419867
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Entity Type | Individual
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Provider Name | TANNER ZIMMERMAN DC
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Gender | Male
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Dates
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Enumeration Date | 02/15/2024
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 2721 STANGE RD STE 108
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City | AMES
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State | IA
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Zip | 50010-3978
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Country | US
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Telephone | 515-291-1990
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Fax |
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Provider Business Mailing Address
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Address Line | 120 JADE ST UNIT 308
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City | AMES
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State | IA
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Zip | 50010-8683
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Country | US
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Telephone | 515-205-6996
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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 | 122783
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License Number State | IA
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