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NPI Code Detail

MEDICARE: DR. CHERYLE ANN PETTIGREW D.C.

MEDICARE: DR. CHERYLE ANN PETTIGREW D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor31909CA
2111N00000XChiropractorB01524NV

General Provider Information

NPI Number : 1134428121
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHERYLE ANN PETTIGREW D.C.
Provider Business Mailing Address
First Line : 10300 W CHARLESTON BLVD
Second Line : 10
City : LAS VEGAS
State : NV
Zip : 89135-1037
Country : US
Telephone Number : 702-878-2225
Fax Number :
Provider Business Practice Location Address
First Line : 10300 W CHARLESTON BLVD
Second Line : 10
City : LAS VEGAS
State : NV
Zip : 89135-1037
Country : US
Telephone Number : 702-878-2225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2011
Last Update Date : 12/23/2014

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