Provider Demographics
NPI:1538192760
Name:ZUIDEMA, JEFFREY SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:ZUIDEMA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114W ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1902
Mailing Address - Country:US
Mailing Address - Phone:856-547-6587
Mailing Address - Fax:856-547-6995
Practice Address - Street 1:114W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1902
Practice Address - Country:US
Practice Address - Phone:856-547-6587
Practice Address - Fax:856-547-6995
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00648600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor