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NPI Code Detail

MEDICARE: DR. STEVEN D. PECK D,C

MEDICARE: DR. STEVEN D. PECK 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
1111N00000XChiropractorB348NV

General Provider Information

NPI Number : 1639249071
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN D. PECK D,C
Provider Business Mailing Address
First Line : 4680 S EASTERN AVE STE B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6192
Country : US
Telephone Number : 702-454-4336
Fax Number : 702-454-4268
Provider Business Practice Location Address
First Line : 4680 S EASTERN AVE
Second Line : SUITE B
City : LAS VEGAS
State : NV
Zip : 89119-6192
Country : US
Telephone Number : 702-454-4336
Fax Number : 702-454-4268
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 11/09/2007

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