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General NPI Number Information
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NPI Number | 1962647693
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Entity Type | Organization
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Legal Business Name | ZIMMERMAN.PRO LLC
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 3336 E 32ND ST STE 103
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City | TULSA
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State | OK
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Zip | 74135-4446
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Country | US
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Telephone | 918-895-8899
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Fax | 918-512-4442
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Provider Business Mailing Address
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Address Line | 9817 E 37TH CT
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City | TULSA
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State | OK
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Zip | 74146-2401
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Country | US
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Telephone | 918-895-8899
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Fax | 918-512-4442
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Authorized Official
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Title or Position | DR /OWNER
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Name | DR. JANNELL ZIMMERMAN
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Credential | DC
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Telephone | 918-895-8899
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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 | 3778
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License Number State | OK
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