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NPI Code Detail

MEDICARE: DR. ROBERT V ZIMMER D.C.

MEDICARE: DR. ROBERT V ZIMMER 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
1111N00000XChiropractor547OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1310997407-00OTHEROHBWC
2310997407OTHEROHTAX ID

General Provider Information

NPI Number : 1629071519
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT V ZIMMER D.C.
Provider Business Mailing Address
First Line : 2436 E DOROTHY LN
Second Line :
City : KETTERING
State : OH
Zip : 45420-1155
Country : US
Telephone Number : 937-294-1484
Fax Number : 937-294-7542
Provider Business Practice Location Address
First Line : 2436 E DOROTHY LN
Second Line :
City : KETTERING
State : OH
Zip : 45420-1155
Country : US
Telephone Number : 937-294-1484
Fax Number : 937-294-7542
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 05/04/2020

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