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NPI Code Detail

MEDICARE: KIRK ZIMMERMANN

MEDICARE:   KIRK  ZIMMERMANN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant2018003111MO
2224Z00000XOccupational Therapy AssistantOTA-161HI

General Provider Information

NPI Number : 1053927129
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRK ZIMMERMANN
Provider Business Mailing Address
First Line : 1907 CONGRESS ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63118-1705
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1907 CONGRESS ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63118-1705
Country : US
Telephone Number : 314-565-8853
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2020
Last Update Date : 09/23/2020

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Directions to “ KIRK ZIMMERMANN ” Practice Location

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