Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 10514 | TX |
NPI | 1346386042 |
---|---|
Provider Name | Dr. Robert Bert Zicterman |
First Address | Friendswood, TX 77546-5321 |
Second Address | Friendswood, TX 77546-5321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 08/07/2007 |