Provider Demographics
NPI:1063585339
Name:ZIPP, JEFFREY A (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:ZIPP
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 1:7115 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2906
Mailing Address - Country:US
Mailing Address - Phone:561-318-7432
Mailing Address - Fax:561-429-8983
Practice Address - Street 1:7115 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2906
Practice Address - Country:US
Practice Address - Phone:561-318-7432
Practice Address - Fax:561-429-8983
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005593111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT71250Medicare UPIN
FL22674Medicare ID - Type Unspecified