Organization
MIDDLEWAY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CLARK ZIMMERMAN LAC (PRESIDENT)
(541) 535-5082
Entity
Organization
Contact information
Practice address
88 LAPREE ST, TALENT, OR 97540-6000
(541) 535-5082
(541) 535-3026
Mailing address
PO BOX 960, 88 LAPREE ST., TALENT, OR 97540-0960
(541) 535-5082
(541) 535-3026
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC00920
OR
171100000X
Acupuncturist
Primary
AC00921
OR
171100000X
Acupuncturist
AC170159
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500701484
—
OR
05
—
500704629
—
OR
05
—
500705825
—
OR
Enumeration date
05/11/2017
Last updated
05/11/2017
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