Provider Demographics
NPI:1578646568
Name:NATHAN, DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:NATHAN
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 1:698 E WETMORE RD
Mailing Address - Street 2:SUITE 460
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-1751
Mailing Address - Country:US
Mailing Address - Phone:520-408-2225
Mailing Address - Fax:520-293-1788
Practice Address - Street 1:698 E WETMORE RD
Practice Address - Street 2:SUITE 460
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1751
Practice Address - Country:US
Practice Address - Phone:520-408-2225
Practice Address - Fax:520-293-1788
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0236700Medicare ID - Type Unspecified
AZ4727Medicare UPIN