Provider Demographics
NPI:1811229446
Name:BLANTON, NATHAN ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ARTHUR
Last Name:BLANTON
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 1:2510 WADE HAMPTON BLVD STE B1
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-1172
Mailing Address - Country:US
Mailing Address - Phone:864-268-8196
Mailing Address - Fax:864-268-8198
Practice Address - Street 1:2510 WADE HAMPTON BLVD STE B1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-1172
Practice Address - Country:US
Practice Address - Phone:864-268-8196
Practice Address - Fax:864-268-8198
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor