Provider Demographics
NPI:1629696430
Name:NLMDC PLLC
Entity Type:Organization
Organization Name:NLMDC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:LEROY
Authorized Official - Last Name:MOON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-313-1420
Mailing Address - Street 1:10050 W BELL RD STE 14
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-1288
Mailing Address - Country:US
Mailing Address - Phone:928-275-1326
Mailing Address - Fax:623-972-8068
Practice Address - Street 1:10050 W BELL RD STE 14
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-1288
Practice Address - Country:US
Practice Address - Phone:928-275-1326
Practice Address - Fax:623-972-8068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty