Provider Demographics
NPI:1871779918
Name:ZOOK, WARREN JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:JOSEPH
Last Name:ZOOK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 HIGHWAY 25 N STE 102
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-1948
Mailing Address - Country:US
Mailing Address - Phone:763-600-1111
Mailing Address - Fax:
Practice Address - Street 1:1111 HIGHWAY 25 N STE 102
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-1948
Practice Address - Country:US
Practice Address - Phone:763-600-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-19
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNDC4133111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU87457Medicare UPIN