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Individual

DR. NATHANIEL ROBERT HISS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
6215 COVINGTON RD, FORT WAYNE, IN 46804-7311
(260) 755-5953
(260) 755-5956
Mailing address
6215 COVINGTON RD, FORT WAYNE, IN 46804-7311
(260) 755-5953
(260) 755-5956

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002335A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000539789
ANTHEM
IN
05
200877260A
IN
Enumeration date
08/28/2007
Last updated
07/15/2013
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