Provider Demographics
NPI:1841210879
Name:IRWIN, NATHAN M (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:M
Last Name:IRWIN
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 1:2531 S SHIELDS ST STE 2H
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1857
Mailing Address - Country:US
Mailing Address - Phone:970-472-8333
Mailing Address - Fax:970-472-8332
Practice Address - Street 1:2531 S SHIELDS ST STE 2H
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1857
Practice Address - Country:US
Practice Address - Phone:970-472-8333
Practice Address - Fax:970-472-8332
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor