MEDICARE: DR. JEROME JAMES ZORTMAN 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	4390	IA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350021881	OTHER	IA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	20581	OTHER	IA	BCBS

General Provider Information

NPI Number	:	1790780328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEROME JAMES ZORTMAN D.C.

Provider Business Mailing Address
First Line	:	250 W FIRST STREET
Second Line	:	SUITE D
City	:	GRIMES
State	:	IA
Zip	:	50111-2138
Country	:	US
Telephone Number	:	515-986-2233
Fax Number	:	515-986-0041

Provider Business Practice Location Address
First Line	:	250 W FIRST STREET
Second Line	:	STE D
City	:	GRIMES
State	:	IA
Zip	:	50111-2138
Country	:	US
Telephone Number	:	515-986-2233
Fax Number	:	515-986-0041

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	11/16/2009

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