Provider Demographics
NPI:1760507545
Name:NEUBAUER, NATHAN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:MICHAEL
Last Name:NEUBAUER
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 1:1316 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-3453
Mailing Address - Country:US
Mailing Address - Phone:507-359-7622
Mailing Address - Fax:507-354-7736
Practice Address - Street 1:1316 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-3453
Practice Address - Country:US
Practice Address - Phone:507-359-7622
Practice Address - Fax:507-354-7736
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor