Healthcare Provider Details

I. General information

NPI: 1215092176
Provider Name (Legal Business Name): GEORGIA J. NAB D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. GEORGIA J. OHLBERG

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 03/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7410 SWITZER ST
SHAWNEE KS
66203-4550
US

IV. Provider business mailing address

7613 JOHNSON DR
OVERLAND PARK KS
66202-2201
US

V. Phone/Fax

Practice location:
  • Phone: 316-641-0926
  • Fax:
Mailing address:
  • Phone: 316-641-0926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4604
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number4604
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: