Individual
IAN K ZIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 LATROBE DR STE B, CHARLOTTE, NC 28211-5227
(704) 612-6537
Mailing address
14217 WATERFOWL LN, CHARLOTTE, NC 28262-1644
(919) 309-5060
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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