MEDICARE: DR. BRIAN K. FIFE 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	B00612	NV

General Provider Information

NPI Number	:	1528192283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN K. FIFE D.C.

Provider Business Mailing Address
First Line	:	4116 W CRAIG RD
Second Line	:	SUITE 100
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-2732
Country	:	US
Telephone Number	:	702-655-1199
Fax Number	:	702-646-0630

Provider Business Practice Location Address
First Line	:	4116 W CRAIG RD
Second Line	:	SUITE 100
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-2732
Country	:	US
Telephone Number	:	702-655-1199
Fax Number	:	702-646-0630

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/11/2010

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