Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 5112 | CO |
Y | 111NR0400X | Rehabilitation Chiropractor | 5112 | CO |
N | 111NX0100X | Occupational Health | 5112 | CO |
NPI | 1649488339 |
---|---|
Provider Name | Dr. Nathan C Ginn |
First Address | Greeley, CO 80634-5434 |
Second Address | Greeley, CO 80634-5426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 12/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U96151 | (02) | CO |