MEDICARE: COLLIN HISAO HIGO 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	B01464	NV
2	111N00000X	Chiropractor	32278	CA

General Provider Information

NPI Number	:	1427483809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLIN HISAO HIGO D.C.

Provider Business Mailing Address
First Line	:	8910 W TROPICANA AVE STE 6
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8131
Country	:	US
Telephone Number	:	702-944-4673
Fax Number	:

Provider Business Practice Location Address
First Line	:	8910 W TROPICANA AVE STE 6
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8131
Country	:	US
Telephone Number	:	702-944-4673
Fax Number	:

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

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	09/04/2013

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