Provider Demographics
NPI:1629397716
Name:RAINS, NATHAN TIMOTHY (OD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:TIMOTHY
Last Name:RAINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 E PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1307
Mailing Address - Country:US
Mailing Address - Phone:970-221-2222
Mailing Address - Fax:970-221-4286
Practice Address - Street 1:1725 E PROSPECT RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1307
Practice Address - Country:US
Practice Address - Phone:970-221-2222
Practice Address - Fax:970-221-4286
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0002969152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist