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General NPI Number Information
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NPI Number | 1902207681
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Entity Type | Individual
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Provider Name | JOSEPH ZIMMERMAN PTA
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Gender | Male
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 09/12/2014
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Provider Practice Location Address
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Address Line | 30265 COMMERCE DR
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City | MILLSBORO
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State | DE
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Zip | 19966-3593
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Country | US
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Telephone | 302-934-1783
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Fax | 302-934-1792
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Provider Business Mailing Address
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Address Line | 30182 REGATTA BAY BLVD
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City | LEWES
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State | DE
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Zip | 19958-6801
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Country | US
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Telephone | 717-805-5928
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | J2-0000769
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License Number State | DE
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