MEDICARE: CHIROPRACTIC HEALTH CENTER

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	111NN1001X	Nutrition Chiropractor	B-407	NV

General Provider Information

NPI Number	:	1639311756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC HEALTH CENTER

Provider Business Mailing Address
First Line	:	2267 CANDLESTICK AVE
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-2361
Country	:	US
Telephone Number	:	702-496-0636
Fax Number	:

Provider Business Practice Location Address
First Line	:	3227 E WARM SPRINGS RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3179
Country	:	US
Telephone Number	:	702-597-1181
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID B COHEN
Credential	:	DC
Telephone Number	:	702-597-1181

Provider Enumeration Date	:	04/03/2009
Last Update Date	:	04/03/2009

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