Provider Demographics
NPI:1740172881
Name:NOLAN SPORT & FAMILY CHIROPRACTIC CORP.
Entity type:Organization
Organization Name:NOLAN SPORT & FAMILY CHIROPRACTIC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:I
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-918-7436
Mailing Address - Street 1:81 DONNA WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-5037
Mailing Address - Country:US
Mailing Address - Phone:310-918-7436
Mailing Address - Fax:
Practice Address - Street 1:5707 REDWOOD RD STE 7
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-2400
Practice Address - Country:US
Practice Address - Phone:510-610-9210
Practice Address - Fax:510-389-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty