MEDICARE: DR. NICHOLAS RYAN WEBER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	007241	IA

General Provider Information

NPI Number	:	1922306976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS RYAN WEBER D.C.

Provider Business Mailing Address
First Line	:	212 S EAST ST
Second Line	:
City	:	ROCK RAPIDS
State	:	IA
Zip	:	51246-1754
Country	:	US
Telephone Number	:	641-583-2422
Fax Number	:

Provider Business Practice Location Address
First Line	:	909 S UNION ST
Second Line	:
City	:	ROCK RAPIDS
State	:	IA
Zip	:	51246-1905
Country	:	US
Telephone Number	:	712-472-4732
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2011
Last Update Date	:	08/21/2013

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