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General NPI Number Information
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NPI Number | 1912223785
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Entity Type | Individual
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Provider Name | RIAN EVERETT ZIMMERMAN ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | 2101 N WARE RD
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City | MCALLEN
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State | TX
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Zip | 78501-3506
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Country | US
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Telephone | 956-632-5148
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 HERON AVE
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City | MCALLEN
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State | TX
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Zip | 78504-3924
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Country | US
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Telephone | 956-532-4089
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT2376
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License Number State | TX
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