Provider Demographics
NPI:1851756209
Name:NEBIKER CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:NEBIKER CHIROPRACTIC LLC
Other - Org Name:TRI COUNTY CHIROPRACTIC OF ST MARYS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:NEBIKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-576-1234
Mailing Address - Street 1:775 KINGS BAY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-9998
Mailing Address - Country:US
Mailing Address - Phone:912-576-1234
Mailing Address - Fax:
Practice Address - Street 1:775 KINGS BAY ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:ST MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-9998
Practice Address - Country:US
Practice Address - Phone:912-576-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty