Provider Demographics
NPI:1679220222
Name:100 CHIRO NUTTY HINES, PC
Entity Type:Organization
Organization Name:100 CHIRO NUTTY HINES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:NUTTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-217-0895
Mailing Address - Street 1:858 DAWSONVILLE HWY STE 890-C
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:858 DAWSONVILLE HWY STE 890-C
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2617
Practice Address - Country:US
Practice Address - Phone:719-217-0895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty