Provider Demographics
NPI:1588079131
Name:LAUENSTEIN, NATHAN KYLE (DC)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:KYLE
Last Name:LAUENSTEIN
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 1:15811 W DODGE RD STE 152
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-4013
Mailing Address - Country:US
Mailing Address - Phone:402-999-8166
Mailing Address - Fax:402-934-7681
Practice Address - Street 1:15811 W DODGE RD STE 152
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-4013
Practice Address - Country:US
Practice Address - Phone:402-999-8166
Practice Address - Fax:402-934-7681
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1796111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor