Provider Demographics
NPI:1144265687
Name:ZWIENER CHIROPRACTIC CLINIC INC., P.S.
Entity type:Organization
Organization Name:ZWIENER CHIROPRACTIC CLINIC INC., P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ZWIENER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-735-7474
Mailing Address - Street 1:7303 W CANAL DR
Mailing Address - Street 2:STE B101
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-6605
Mailing Address - Country:US
Mailing Address - Phone:509-735-7474
Mailing Address - Fax:509-735-6011
Practice Address - Street 1:7303 W CANAL DR
Practice Address - Street 2:STE B101
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-6605
Practice Address - Country:US
Practice Address - Phone:509-735-7474
Practice Address - Fax:509-735-6011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA18193OtherL I
WA2002046Medicaid
WA000301783Medicare ID - Type Unspecified
WA2002046Medicaid