Provider Demographics
NPI:1972883999
Name:BRAATEN, NICHOLAS CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:CHARLES
Last Name:BRAATEN
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 1:7532 CLIFFORD CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-9650
Mailing Address - Country:US
Mailing Address - Phone:661-978-0627
Mailing Address - Fax:
Practice Address - Street 1:1001 TOWER WAY STE 130
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1586
Practice Address - Country:US
Practice Address - Phone:661-327-2622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor