Provider Demographics
NPI:1790449478
Name:FIVE POINTS FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:FIVE POINTS FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:AMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NUHANOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-830-4326
Mailing Address - Street 1:801 OREGON ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-2434
Mailing Address - Country:US
Mailing Address - Phone:319-830-4326
Mailing Address - Fax:
Practice Address - Street 1:334 E RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5042
Practice Address - Country:US
Practice Address - Phone:319-252-4510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty