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NPI Code Detail

MEDICARE: JONATHAN DAI DC

MEDICARE: JONATHAN DAI 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
1111NS0005XSports Physician ChiropractorB01942NV
2111N00000XChiropractorB01942NV

General Provider Information

NPI Number : 1710602412
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN DAI DC
Provider Business Mailing Address
First Line : 8997 S PARK ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89178-3860
Country : US
Telephone Number : 702-232-9842
Fax Number :
Provider Business Practice Location Address
First Line : 5980 S DURANGO DR STE 113-114
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1779
Country : US
Telephone Number : 702-773-2340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2022
Last Update Date : 10/27/2022

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Directions to “ JONATHAN DAI DC” Practice Location

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