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General NPI Number Information
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NPI Number | 1588671192
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Entity Type | Individual
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Provider Name | LARE ZIEMBA D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 433 NW PRIMA VISTA BLVD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-8731
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Country | US
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Telephone | 772-337-3141
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Fax | 772-336-1160
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Provider Business Mailing Address
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Address Line | 433 NW PRIMA VISTA BLVD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-8731
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Country | US
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Telephone | 772-337-3141
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Fax | 772-336-1160
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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 | CHOOO6248
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License Number State | FL
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