Provider Demographics
NPI:1295040343
Name:ZUMSTEIN CHIROPRACTIC CLINIC, L.L.C.
Entity type:Organization
Organization Name:ZUMSTEIN CHIROPRACTIC CLINIC, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:ZUMSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:414-761-3330
Mailing Address - Street 1:8233 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9310
Mailing Address - Country:US
Mailing Address - Phone:414-761-3330
Mailing Address - Fax:414-761-3363
Practice Address - Street 1:8233 S. 27TH ST.
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132
Practice Address - Country:US
Practice Address - Phone:414-761-3330
Practice Address - Fax:414-761-3363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3436-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38949800Medicaid
WI1629168455OtherNPI TYPE 1
WI000035366Medicare PIN
WI1629168455OtherNPI TYPE 1