Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 14051 | TX |
NPI | 1083173173 |
---|---|
Provider Name | Patricia Colleen Ziperovich |
First Address | Dallas, TX 75204-5725 |
Second Address | Dallas, TX 75244-4629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2019 |
Last Update Date | 14/09/2020 |