MEDICARE: STEPHEN J CHIARELLO LTD

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	1000050-205	NV

General Provider Information

NPI Number	:	1730479155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN J CHIARELLO LTD

Provider Business Mailing Address
First Line	:	2815 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5307
Country	:	US
Telephone Number	:	702-362-6303
Fax Number	:	702-362-6607

Provider Business Practice Location Address
First Line	:	2815 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5307
Country	:	US
Telephone Number	:	702-362-6303
Fax Number	:	702-362-6607

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. STEPHEN J CHIARELLO
Credential	:	DC
Telephone Number	:	702-362-6303

Provider Enumeration Date	:	04/19/2011
Last Update Date	:	12/07/2011

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