Provider Demographics
NPI:1912378035
Name:NASHUA FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:NASHUA FAMILY CHIROPRACTIC PC
Other - Org Name:CLARKSVILLE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ANTHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:319-278-1100
Mailing Address - Street 1:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50619-0106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:109 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IA
Practice Address - Zip Code:50619-2022
Practice Address - Country:US
Practice Address - Phone:319-278-1100
Practice Address - Fax:319-278-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty