Provider Demographics
NPI:1972179778
Name:ZEBEDEE, JACOB THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:THOMAS
Last Name:ZEBEDEE
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 1:125 N HOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:BLUE EARTH
Mailing Address - State:MN
Mailing Address - Zip Code:56013-1228
Mailing Address - Country:US
Mailing Address - Phone:507-327-9564
Mailing Address - Fax:
Practice Address - Street 1:118 W 2ND ST
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-1718
Practice Address - Country:US
Practice Address - Phone:507-327-9564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor