Provider Demographics
NPI:1801126859
Name:NICHOLAS, NATHAN AARON (DC)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:AARON
Last Name:NICHOLAS
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 1:1315 LANSING RD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-8421
Mailing Address - Country:US
Mailing Address - Phone:517-303-7777
Mailing Address - Fax:
Practice Address - Street 1:1315 LANSING RD
Practice Address - Street 2:SUITE 1000
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-8421
Practice Address - Country:US
Practice Address - Phone:517-303-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009568111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor