Healthcare Provider Details

I. General information

NPI: 1760870190
Provider Name (Legal Business Name): NLCANADA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 2ND ST NE
BONDURANT IA
50035-1336
US

IV. Provider business mailing address

210 2ND ST NE
BONDURANT IA
50035-1336
US

V. Phone/Fax

Practice location:
  • Phone: 515-967-6500
  • Fax: 515-967-6544
Mailing address:
  • Phone: 515-967-6500
  • Fax: 515-967-6544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number06777
License Number StateIA

VIII. Authorized Official

Name: DR. NICOLE LEE HARMEL
Title or Position: PHYSICIAN OWNER
Credential: DC
Phone: 515-967-6500