MEDICARE: DR. TUCKER BRAIDEN ELSNER DC

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	B02027	NV

General Provider Information

NPI Number	:	1619739091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TUCKER BRAIDEN ELSNER DC

Provider Business Mailing Address
First Line	:	217 BLAKELAND DR
Second Line	:
City	:	SPRING CREEK
State	:	NV
Zip	:	89815-6145
Country	:	US
Telephone Number	:	775-934-8722
Fax Number	:

Provider Business Practice Location Address
First Line	:	263 SPRING VALLEY PKWY STE E
Second Line	:
City	:	SPRING CREEK
State	:	NV
Zip	:	89815-6826
Country	:	US
Telephone Number	:	775-753-9395
Fax Number	:

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

Provider Enumeration Date	:	01/30/2024
Last Update Date	:	01/30/2024

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