MEDICARE: DR. IRENE LIN 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
1	111N00000X	Chiropractor	B973	NV

General Provider Information

NPI Number	:	1336210822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRENE LIN D.C.

Provider Business Mailing Address
First Line	:	4528 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1502
Country	:	US
Telephone Number	:	702-382-7753
Fax Number	:	702-382-7753

Provider Business Practice Location Address
First Line	:	4528 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1502
Country	:	US
Telephone Number	:	702-382-7753
Fax Number	:	702-382-7753

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. IRENE LIN D.C.” Practice Location

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