MEDICARE: JEFFREY ALAN ZWIERSTRA D.C.

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
1	111N00000X	Chiropractor	10761	TX

General Provider Information

NPI Number	:	1376727198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY ALAN ZWIERSTRA D.C.

Provider Business Mailing Address
First Line	:	5310 N TARRANT PKWY STE 132
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-7300
Country	:	US
Telephone Number	:	817-849-2165
Fax Number	:	817-849-2208

Provider Business Practice Location Address
First Line	:	5310 N TARRANT PKWY STE 132
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-7300
Country	:	US
Telephone Number	:	817-849-2165
Fax Number	:	817-849-2208

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2007
Last Update Date	:	09/15/2022

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