Provider Demographics
NPI:1447211214
Name:ONCKEN, NATHANIEL CHRISTIAN (DC)
Entity Type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:CHRISTIAN
Last Name:ONCKEN
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 1:423 CALHOUN AVE
Mailing Address - Street 2:B
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-2015
Mailing Address - Country:US
Mailing Address - Phone:864-223-2224
Mailing Address - Fax:864-223-2225
Practice Address - Street 1:423 CALHOUN AVE
Practice Address - Street 2:B
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-2015
Practice Address - Country:US
Practice Address - Phone:864-223-2224
Practice Address - Fax:864-223-2225
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3107111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH3107Medicaid