Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CH7885 | FL |
NPI | 1063555720 |
---|---|
Provider Name | Dr. Alan A Nathans |
First Address | Jacksonville, FL 32256-7422 |
Second Address | Jacksonville, FL 32256-7422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CH7885 | LICENSE NUMBER (01) | FL |