Provider Demographics
NPI:1649488339
Name:GINN, NATHAN C (DC)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:C
Last Name:GINN
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 1:2928 W 10TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-5434
Mailing Address - Country:US
Mailing Address - Phone:970-324-1750
Mailing Address - Fax:
Practice Address - Street 1:2928 W 10TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-5426
Practice Address - Country:US
Practice Address - Phone:970-324-1750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5112111N00000X, 111NX0100X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor
No111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU96151Medicare UPIN
CO505338Medicare ID - Type Unspecified