Provider Demographics
NPI:1881650661
Name:LAUBACH, NATHAN RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:RICHARD
Last Name:LAUBACH
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 1:2369 ROUTE 715
Mailing Address - Street 2:
Mailing Address - City:TANNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18372
Mailing Address - Country:US
Mailing Address - Phone:570-629-9507
Mailing Address - Fax:272-200-2977
Practice Address - Street 1:2369 ROUTE 715
Practice Address - Street 2:
Practice Address - City:TANNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18372
Practice Address - Country:US
Practice Address - Phone:570-629-9507
Practice Address - Fax:272-200-2977
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7640701000OtherIND BLUE CROSS
PALA1802442OtherBLUE CROSS BLUE SHIELD
PA108885OtherOPER. ENGINEERS LOCAL 825
PA7640701000OtherIND BLUE CROSS