Provider Demographics
NPI:1396268140
Name:KHAN, NATHANIEL F (DC)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:F
Last Name:KHAN
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 1:302 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036-2518
Mailing Address - Country:US
Mailing Address - Phone:515-298-0515
Mailing Address - Fax:
Practice Address - Street 1:228 MAMIE EISENHOWER AVE
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:IA
Practice Address - Zip Code:50036-3426
Practice Address - Country:US
Practice Address - Phone:515-298-0515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA088321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty