Provider Demographics
NPI:1013299882
Name:NEW HORIZON CHIROPRACTIC & WELLNESS CENTER, PLLC
Entity Type:Organization
Organization Name:NEW HORIZON CHIROPRACTIC & WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-757-2225
Mailing Address - Street 1:2100 S COLUMBIA RD
Mailing Address - Street 2:114
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-5895
Mailing Address - Country:US
Mailing Address - Phone:701-757-2225
Mailing Address - Fax:701-757-0740
Practice Address - Street 1:2100 S COLUMBIA RD
Practice Address - Street 2:114
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-5895
Practice Address - Country:US
Practice Address - Phone:701-757-2225
Practice Address - Fax:701-757-0740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND890111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1518265362Medicaid
ND16537Medicaid
NDN717180Medicare PIN