Provider Demographics
NPI:1427834464
Name:ZIES, CARL THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:THOMAS
Last Name:ZIES
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 1:1833 MARKETPLACE DR SE
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-8506
Mailing Address - Country:US
Mailing Address - Phone:616-522-5610
Mailing Address - Fax:616-312-2585
Practice Address - Street 1:1833 MARKETPLACE DR SE
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-8506
Practice Address - Country:US
Practice Address - Phone:616-522-5610
Practice Address - Fax:616-312-2585
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23244100935111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor