Provider Demographics
NPI:1184150047
Name:NATHANIEL C. PEERY, D.C., A CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:NATHANIEL C. PEERY, D.C., A CHIROPRACTIC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:PEERY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-605-3701
Mailing Address - Street 1:1465 VICTOR AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4856
Mailing Address - Country:US
Mailing Address - Phone:530-605-3701
Mailing Address - Fax:530-605-3702
Practice Address - Street 1:1465 VICTOR AVE
Practice Address - Street 2:SUITE A
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-4856
Practice Address - Country:US
Practice Address - Phone:530-605-3701
Practice Address - Fax:530-605-3702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHF610AMedicare UPIN