Provider Demographics
NPI:1649440249
Name:NELSON, COLBY T (DC)
Entity type:Individual
Prefix:DR
First Name:COLBY
Middle Name:T
Last Name:NELSON
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 1:960 W CHERRY ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-9813
Mailing Address - Country:US
Mailing Address - Phone:515-231-7499
Mailing Address - Fax:
Practice Address - Street 1:127 MARION BLVD STE B
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-3144
Practice Address - Country:US
Practice Address - Phone:319-447-1317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007074111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor