Provider Demographics
NPI:1326399411
Name:NANTICOKE CHIROPRACTIC & WEIGHT LOSS CENTER,INC
Entity Type:Organization
Organization Name:NANTICOKE CHIROPRACTIC & WEIGHT LOSS CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-628-8706
Mailing Address - Street 1:415 W STEIN HWY
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-1239
Mailing Address - Country:US
Mailing Address - Phone:302-628-8706
Mailing Address - Fax:
Practice Address - Street 1:415 W STEIN HWY
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-1239
Practice Address - Country:US
Practice Address - Phone:302-628-8706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000452111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty