Dakota Lee Zickefoose, D.C.
Individual provider Active NPI Pediatric Chiropractor · Loudonville, OH
NPI 1659813988 · NPPES record last updated Nov 17, 2016
Key facts
- NPI
- 1659813988
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Chiropractor 111NP0017X
- License
- 4643 (OH)
- Practice address
- 241 W Main St
Loudonville, OH 44842-1135 - Phone
- (419) 994-2424
- Fax
- (567) 223-6067
- NPI assigned
- Nov 17, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4643 | OH | MD | Pediatric Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Chiropractor | 111NP0017X | 4643 | OH | Yes |
Addresses
Primary practice location
241 W Main St
Loudonville, OH 44842-1135
Mailing address
241 W Main St
Loudonville, OH 44842-1135
Phone (419) 994-2424
Other providers in Loudonville, OH
- David J Tomchak
- Kimberly Dawn Tungate
- Village of Loudonville
- WSW. Inc. Dba Danner'S Drug
- Noah Alan Yarman
All providers in Loudonville, OH · Pediatric Chiropractor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.