Provider Demographics
NPI:1215366240
Name:ALBERT, NICHOLAS ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ANDREW
Last Name:ALBERT
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:W188 S7830 RACINE AVENUE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150
Mailing Address - Country:US
Mailing Address - Phone:262-349-0845
Mailing Address - Fax:
Practice Address - Street 1:W188S7830 RACINE AVE STE 100
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-8298
Practice Address - Country:US
Practice Address - Phone:262-349-0845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4955-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor