Provider Demographics
NPI:1861739302
Name:ZIMMERMAN, LORRAINE JESSICA (DC)
Entity type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:JESSICA
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 MONTOUR ST
Mailing Address - Street 2:
Mailing Address - City:MONTOUR FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14865-9669
Mailing Address - Country:US
Mailing Address - Phone:607-535-6094
Mailing Address - Fax:607-535-7232
Practice Address - Street 1:216 MONTOUR ST
Practice Address - Street 2:
Practice Address - City:MONTOUR FALLS
Practice Address - State:NY
Practice Address - Zip Code:14865-9669
Practice Address - Country:US
Practice Address - Phone:607-535-6094
Practice Address - Fax:607-535-7232
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012294111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor