Provider Demographics
NPI:1063943454
Name:JAMES, NATHAN (DC)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:JAMES
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 1:208 NE 19TH DR
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-1932
Mailing Address - Country:US
Mailing Address - Phone:772-463-2344
Mailing Address - Fax:772-463-9565
Practice Address - Street 1:208 NE 19TH DR
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-1932
Practice Address - Country:US
Practice Address - Phone:772-463-2344
Practice Address - Fax:772-463-9565
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor