Provider Demographics
NPI:1346994019
Name:MITTON, NATHAN (DC)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:MITTON
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 1:2601 COLUMBINE DR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4511
Mailing Address - Country:US
Mailing Address - Phone:970-317-1611
Mailing Address - Fax:
Practice Address - Street 1:1539 FLORIDA ROAD
Practice Address - Street 2:SUITE 112
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301
Practice Address - Country:US
Practice Address - Phone:970-317-1611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0008504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor