Provider Demographics
NPI:1649467812
Name:CENTRA CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:CENTRA CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:DAN
Authorized Official - Last Name:SCHILATY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-663-6677
Mailing Address - Street 1:1762 HOFFMAN DR
Mailing Address - Street 2:STE. H
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4292
Mailing Address - Country:US
Mailing Address - Phone:970-663-6677
Mailing Address - Fax:
Practice Address - Street 1:1762 HOFFMAN DR
Practice Address - Street 2:STE. H
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4292
Practice Address - Country:US
Practice Address - Phone:970-663-6677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty