MEDICARE: VANCE WHALEY CHIROPRACTIC LLC

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

General Provider Information

NPI Number	:	1356350870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANCE WHALEY CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	8556 DEL WEBB BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-8676
Country	:	US
Telephone Number	:	702-243-2225
Fax Number	:	702-243-5352

Provider Business Practice Location Address
First Line	:	8556 DEL WEBB BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-8676
Country	:	US
Telephone Number	:	702-243-2225
Fax Number	:	702-243-5352

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VANCE F WHALEY
Credential	:	DC
Telephone Number	:	702-243-2225

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	01/23/2008

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