Provider Demographics
NPI:1902517618
Name:ZIMMERMAN SPORTS CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:ZIMMERMAN SPORTS CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-312-1456
Mailing Address - Street 1:30 S SHORE DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-5821
Mailing Address - Country:US
Mailing Address - Phone:850-312-1456
Mailing Address - Fax:
Practice Address - Street 1:30 S SHORE DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-5821
Practice Address - Country:US
Practice Address - Phone:850-312-1456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty