Provider Demographics
NPI:1104205640
Name:NOHL P.C.
Entity Type:Organization
Organization Name:NOHL P.C.
Other - Org Name:NOHL FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:NOHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-751-2459
Mailing Address - Street 1:1201 US HIGHWAY 10 W
Mailing Address - Street 2:UNIT C
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-9022
Mailing Address - Country:US
Mailing Address - Phone:406-222-4444
Mailing Address - Fax:
Practice Address - Street 1:1201 US HIGHWAY 10 W
Practice Address - Street 2:UNIT C
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-9022
Practice Address - Country:US
Practice Address - Phone:406-222-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-3449111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty