Provider Demographics
NPI:1538363288
Name:ZEOLLA, EMILIO L (DC)
Entity type:Individual
Prefix:
First Name:EMILIO
Middle Name:L
Last Name:ZEOLLA
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:PO BOX 18521
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27419-8521
Mailing Address - Country:US
Mailing Address - Phone:336-773-7373
Mailing Address - Fax:336-292-1928
Practice Address - Street 1:1515 HANES MALL BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1358
Practice Address - Country:US
Practice Address - Phone:336-773-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor