Provider Demographics
NPI:1790199206
Name:NASHUA FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:NASHUA FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:641-435-2102
Mailing Address - Street 1:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:IA
Mailing Address - Zip Code:50658-0232
Mailing Address - Country:US
Mailing Address - Phone:641-435-2102
Mailing Address - Fax:641-435-4186
Practice Address - Street 1:12 WOODBRIDGE ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:IA
Practice Address - Zip Code:50658-7772
Practice Address - Country:US
Practice Address - Phone:641-435-2102
Practice Address - Fax:641-435-4186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty