Healthcare Provider Details

I. General information

NPI: 1144081951
Provider Name (Legal Business Name): NILSSEN CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 NW MARTIN LUTHER KING JR BLVD
EVANSVILLE IN
47708-1903
US

IV. Provider business mailing address

319 NW MARTIN LUTHER KING JR BLVD
EVANSVILLE IN
47708-1903
US

V. Phone/Fax

Practice location:
  • Phone: 812-423-9146
  • Fax: 775-766-6516
Mailing address:
  • Phone: 812-423-9146
  • Fax: 775-766-6516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ELLIOTT NILSSEN
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 812-746-5232