Provider Demographics
NPI:1750762241
Name:DISCOVER CHIROPRACTIC LLC
Entity type:Organization
Organization Name:DISCOVER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NANNINGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-251-7977
Mailing Address - Street 1:4656 86TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-1026
Mailing Address - Country:US
Mailing Address - Phone:515-251-7977
Mailing Address - Fax:866-251-2177
Practice Address - Street 1:4656 86TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-1026
Practice Address - Country:US
Practice Address - Phone:515-251-7977
Practice Address - Fax:866-251-2177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA006983111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty