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Organization
ZIMMERMAN CHIROPRACTIC CLINIC PC
Active
Organization
ZIMMERMAN CHIROPRACTIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD WAYNE ZIMMERMAN DC, CCSP. (CHIROPRACTOR/OWNER)
(618) 542-2165
Entity
Organization
Contact information
Practice address
7 E MAIN ST, DU QUOIN, IL 62832-1420
(618) 542-2165
(618) 542-9276
Mailing address
7 E MAIN ST, DU QUOIN, IL 62832-1420
(618) 542-2165
(618) 542-9276
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038007421
—
IL
01
—
07308609
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/15/2010
Last updated
09/15/2010
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