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General NPI Number Information
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NPI Number | 1669502241
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Entity Type | Individual
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Provider Name | CHARLES FREDERICK ZOELLNER D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 4785 E 91ST ST SUITE B
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City | TULSA
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State | OK
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Zip | 74137
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Country | US
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Telephone | 918-488-8600
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Fax | 918-488-9604
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Provider Business Mailing Address
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Address Line | 4785 E 91ST ST SUITE B
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City | TULSA
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State | OK
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Zip | 74137
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Country | US
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Telephone | 918-488-8600
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Fax | 918-488-9604
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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 | 3812
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State | OK
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