Provider Demographics
NPI:1174903322
Name:NOLTING, SIMON
Entity type:Individual
Prefix:
First Name:SIMON
Middle Name:
Last Name:NOLTING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SIMON
Other - Middle Name:
Other - Last Name:NOLTING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:KS
Mailing Address - Zip Code:66066-0304
Mailing Address - Country:US
Mailing Address - Phone:785-863-2334
Mailing Address - Fax:785-746-0352
Practice Address - Street 1:609 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:KS
Practice Address - Zip Code:66066-5431
Practice Address - Country:US
Practice Address - Phone:785-863-2334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor