Provider Demographics
NPI:1124659396
Name:ACCELERATE SPORT AND SPINE, NANCE CHIROPRACTIC INC
Entity type:Organization
Organization Name:ACCELERATE SPORT AND SPINE, NANCE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WAYNE ALEXANDER
Authorized Official - Last Name:NANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:909-255-6899
Mailing Address - Street 1:9650 9TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4590
Mailing Address - Country:US
Mailing Address - Phone:909-255-6899
Mailing Address - Fax:
Practice Address - Street 1:9650 9TH ST STE E
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4590
Practice Address - Country:US
Practice Address - Phone:909-255-6899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty