Provider Demographics
NPI:1215092176
Name:NAB, GEORGIA J (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:J
Last Name:NAB
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:GEORGIA
Other - Middle Name:J
Other - Last Name:OHLBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7613 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2201
Mailing Address - Country:US
Mailing Address - Phone:316-641-0926
Mailing Address - Fax:
Practice Address - Street 1:7410 SWITZER ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-4550
Practice Address - Country:US
Practice Address - Phone:316-641-0926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2019-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4604111NN1001X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060105Medicare ID - Type UnspecifiedPROVIDER ID