Provider Demographics
NPI:1861659484
Name:ALAN NATHANS FAMILY CHIROPRACTIC INC
Entity type:Organization
Organization Name:ALAN NATHANS FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NATHANS
Authorized Official - Suffix:
Authorized Official - Credentials:DC,
Authorized Official - Phone:904-733-7393
Mailing Address - Street 1:11048 BAYMEADOWS RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9699
Mailing Address - Country:US
Mailing Address - Phone:904-733-7393
Mailing Address - Fax:904-363-3397
Practice Address - Street 1:11048 BAYMEADOWS RD
Practice Address - Street 2:SUITE 2
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9699
Practice Address - Country:US
Practice Address - Phone:904-733-7393
Practice Address - Fax:904-363-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7885111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2145Medicare UPIN