Individual
DR. NICHOLAS LOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
335 ELM ST, PENN YAN, NY 14527-1409
(315) 536-8124
(315) 536-6728
Mailing address
335 ELM ST, PENN YAN, NY 14527-1409
(315) 536-8124
(315) 536-6728
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
004727
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004727
STATE LICENSE NUMBER
NY
Enumeration date
03/01/2007
Last updated
07/08/2007
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