Provider Demographics
NPI:1063707610
Name:ZMOOS CHIROPRACTIC CENTER, PLC
Entity type:Organization
Organization Name:ZMOOS CHIROPRACTIC CENTER, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ZMOOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-395-9598
Mailing Address - Street 1:4045 RIVER RIDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-7544
Mailing Address - Country:US
Mailing Address - Phone:319-395-9598
Mailing Address - Fax:319-395-9660
Practice Address - Street 1:4045 RIVER RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-7544
Practice Address - Country:US
Practice Address - Phone:319-395-9598
Practice Address - Fax:319-395-9660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-11
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0221440Medicaid
IAT01263Medicare UPIN
IA221440Medicare PIN