Provider Demographics
NPI:1588947360
Name:SPANGLER, NATHAN ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ALLEN
Last Name:SPANGLER
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 1:3858 N GARDEN CENTER WAY
Mailing Address - Street 2:101
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-5008
Mailing Address - Country:US
Mailing Address - Phone:208-598-4456
Mailing Address - Fax:
Practice Address - Street 1:1625 W STATE ST STE 100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4003
Practice Address - Country:US
Practice Address - Phone:208-336-0017
Practice Address - Fax:208-439-7657
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1478111N00000X
NY013596-01111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor