Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 10984 | TX |
NPI | 1003065848 |
---|---|
Provider Name | Dr. Zachary Thoomas Sumrall |
First Address | Kerrville, TX 78028-4292 |
Second Address | Kerrville, TX 78028-4292 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2008 |
Last Update Date | 17/09/2008 |