Provider Demographics
NPI:1598298432
Name:NATHANIEL LITTMAN DC LLC
Entity Type:Organization
Organization Name:NATHANIEL LITTMAN DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:MICAH
Authorized Official - Last Name:LITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-532-5462
Mailing Address - Street 1:702 OWENS DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:MO
Mailing Address - Zip Code:65536-3501
Mailing Address - Country:US
Mailing Address - Phone:417-532-5462
Mailing Address - Fax:417-532-8595
Practice Address - Street 1:702 OWENS DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:MO
Practice Address - Zip Code:65536-3501
Practice Address - Country:US
Practice Address - Phone:417-532-5462
Practice Address - Fax:417-532-8595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016042144111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty